Caregiver by Design

I work with people in pain almost every day and have discovered that there is no benefit to discounting the pain, trying to tell someone that "pain is gain" or that they have to push through it.   Instead, acknowledging the pain, finding a new focal point of comfort, and teaching an allowance for movement through the pain with the focus of achieving even one degree of less pain after the mobility; is the approach that works time and again.  Chances are that you are no stranger to pain or the effects that it has on your loved one.  You may have fallen into the cycle of allowing for stagnation and compensation because of your loved one's complaints of pain.  Then, noticed that they are doing less for themself, moving less, becoming weaker and ironically enough, developing more pain.   In this episode, you can learn how to get mobility and activity through the limitations of pain by using assisted range of motion, and visualization, combined with breath work, and incorporation of the movement of the body around the source of pain.  Support the showIf you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

In this episode, you will learn how you can use effleurage to help someone's body prepare to move early in the morning, after being still for a long time, or to arouse the brain-to-muscle connection for those with neurological impairments. What is Effleurage massage? A french word defined as "to skim or to touch lightly"I decided to share this topic with you after a rewarding experience I had this week as a clinician using this touch to help an individual who had been bed-bound, and very limited in her active, volitional movement very limited, to help her to participate in my therapy session.  This would be a missed opportunity by many providers because, to be honest, it just seems too simple.  Therapeutic touch and interventions with intention can have a profound impact and should not be overlooked.  This approach used with my patient increased her ability to roll in bed, increased her eye contact, and verbal communication.  What could this touch do to help the one you care for?  It only takes a minute and you can learn how to use it today.An example of the sequence that you can use: effleurage massage (just a few sweeps), followed by assisted movement, then followed by active movement with purpose (such as rolling in bed).  Give the body the opportunity to work.  Be the facilitator of your care recipients potential. Benefits of the use of effleurage:increase arousal/stimulationincrease awarenessprovide comfortdecrease a stress responseDifferent approaches have different effects.  Fast, light, repetitive sweeping motions with the fingertips along the contour of the limb or face are stimulating while slow, heavier pressure with more of the palm of the hand is calming.   Know the needs of your care recipient.  Practice on your own skin (leg or opposite arm) to feel the effects. Using a skill like this is therapeutic and you have all that you need to be therapeutic versus ordinary.   Make a habit of looking for ways to interact with your loved one therapeutically every day and you will find that your caregiving burden lightens over time.  Support the showIf you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Many caregivers feel stuck and experience the following according to https://www.whereyoulivematters.org/caregiver-burnout-caring-for-aging-parents/55% of CG feel overwhelmed by the amount of care they provide18hrs is the average amount of time spent providing care 1 in 5 CG report physical strain due to CGing dutiesAre these numbers your destiny? What areas can you take control over and how can you start making changes today that will help you to avoid falling into these statistics?  The largest contributing factor to all of the above areas is the care recipient's level of independence and how much is required of the CG.  What can you do to increase your recipient's independence?   recognize the areas that your care recipient is leaning on you too much for.  The areas where they have declined in the quality of movement.  Where are you seeing weakness, stiffness, pain?  What can be done to make improvements in these areas? Developing their independence is a key to avoiding the "overwhelm by the amount of care" required Make a goal to decrease the number of hours spent providing care, again by increasing their independence in any way possible Pay attention to the risk factors associated with your physical injury or progressive strain placed on your body during CG duties and make adjustments that focus on decreasing those risks.How do you transition?  Begin coaching your loved one to greater independence vs providing the "done for you" approach.  It is unconventional to consider using a "do it yourself" approach to your care recipient but I challenge you to give it a try.  This is the rehab approach that will make a difference in both of your lives. Take a few minutes to watch this free training video i made for you  https://www.caregiverbydesign.com/freetraining You know you need more help and are ready to start.  This is for you. https://www.caregiverbydesign.com/coachingSupport the showIf you need more help/support on your caregiving journey, you can find it over at https://www.caregiverbydesign.com/coaching Free training now : watch a short free video I created on coaching vs caregiving https://www.caregiverbydesign.com/freetraining

Skin breakdown can have a life-threatening impact and it can sneak up on you and your loved one.  You can avoid it and you can also make quick changes to help promote the healing of this condition.   Here is what happens: pressure applied to the surface tension of the skin diminishes blood flow to the skin and can have very negative results in as little as 1-2hrs.  A serious skin breakdown can develop into an open pressure sore within just one week.  An advancing open sore can become serious and lead to complications within 1 month.  Here are some examples of seriously negative complications from skin breakdown: cellulitisbone and joint infectioncancersepsisRisk factors associated with the development of skin breakdown: Immobility or decline in mobilityincontinence of urine and/or stoolimpaired sensation of skinpoor nutritionpoor blood flowYou can avoid the potential development of skin breakdown by making sure that your loved one can adjust their own position frequently and that they are not sitting on a hard surface for any period of time greater than an hour if they are at risk.   If they can't reposition their own body, take a close look at why and how to help them develop this skill.  (MORE on this to come, so stay tuned) .  Use non skin shearing surfaces to help mobilize them if you have to do all the work. Use pressure-relieving cushions to help reduce the risk of pressure sores.  (low air loss mattresses, chair cushions that are air-filled or gel-filled) signs of skin breakdown in orderred skin that may be warm and your LO complains of itchy or burning sensation or painpurple colored skin that is more painful or may have lost some of the sensation open area has developed and may be oozingSupport the show

Pain is something that we all can relate to on some level.  Unfortunately, it is one of the most limiting factors for our seniors and for those facing chronic illness or progressive disease.   Did you know that the lack of joint mobility produced by getting up and moving around/walking or rolling in bed, increases a person's pain because of these factors?    fluid builds up around the joint when a joint is immobile muscle atrophy can cause painpain elicits fear which limits movement Intervention for pain is often a missed opportunity for the use of NONmedication/pharmaceutical options that work even better than the average go-to medication choice are discussed in this episode.    The elderly population and those with chronic illnesses are at a disadvantage when it comes to pain management because of how medications are prescribed.   What if you could ease their pain without adding another medication?  I have seen it work and I encourage you to experience it as a recipient first so that you can possibly deliver relief to your loved one in the same way.  myofascial releasemeditationhypnosisYou can develop the skills to help your loved one with pain and see the relief they experience and then utilize their less painful state to increase their mobility.  Remember the less they move, the more they feel the pain.   So, don't be afraid to teach them how to move through some pain and to address the pain, validating it and attempting to find a solution for it, each and every time.  help with guided meditation @ the mindful movement: https://youtu.be/UWOwrPW5mqwpain management article sighted in this episode: https://www.practicalpainmanagement.com/treatments/pain-management-elderlybreathing video : (min 2:30 for diaphragmatic breathing) https://youtu.be/V5gfoxdv9k8get direct help/work with me: https://www.caregiverbydesign.com/coachinguse my therapy strategy at home: https://www.caregiverbydesign.com/freetrainingSupport the show (https://angierischpater.mykajabi.com)

Episode 51How can one person's fall destine them to nursing home placement while another suffers different injuries that could be seen as more limiting, yet they are able to return to their prior living situation?   I share the differences between the factors of recovery in this episode chronic and progressive illnessmotivation factorssupport systemsperspective environmental factorsHave you ever wondered what OT is and how it's different from PT?  I have been an OT for 23 years and I still have to explain it to people.  I discuss how an OT approaches solving the challenge that someone who has fallen and can't use their arms or their legs for mobility or daily activity, and how you, the caregiver, have the same potential.  You just need to know where to start, what barriers to eliminate, and how to maximize potential at every point.  Too often, caregivers limit TOO much of their loved one's opportunities and in so doing, they contribute to increased risk of weakness, balance disturbance, endurance limitations, fear of mobility, and more.    I share some tips with you here.   I know that caregivers can successfully master a DIY rehab approach at home and avoid the avoidable costs of hospital stays, nursing homes, rehab costs, and related costs of illness and injury.    Wondering how to get more help?  Learn how to set a clear goal with your personal needs as the main vision.  Design your caregiving experience with intention.   I have a free training here that I know will help you TODAY:   https://www.caregiverbydesign.com/freetrainingWhen you are ready to jump-start your DIY rehab at home, join this coaching series: https://www.caregiverbydesign.com/coachingOther media outlets where you can see me and interact: https://www.youtube.com/channel/UCkf3lSUFi2ER0_i33go5k2gTikTok: https://www.tiktok.com/@thecaregiverFB: https://www.facebook.com/caregiverbydesignIG: https://www.instagram.com/caregive_bydesignSupport the show (https://angierischpater.mykajabi.com)

I don't know of anyone who actually wants to go to a nursing home or wants to have their loved one require that level of care, but it happens.  You have probably heard stories of people who fell, broke a hip, and then somehow never come home again.  You might wonder how one thing, like a fall, leads to such an undesirable outcome.  Well, I am going to tell you.   Then, I am going to tell you what can be done differently to avoid that outcome.  Here are the major factors that lead to needing a higher level of care like a nursing home: lack of additional support coming into the home as neededchronic illness/progressive illness or disease regression in mobility and strengthdecline in endudrancedecline in appetite/food intake/nutritionfailing to eliminate the cause of the initial fall/injury complacency repeat injury All of the above tend to occur but it doesn't take all of them to cause the need for long-term care.   In this episode, I am sharing with you the story of someone who found themselves in this situation, and then I share what could have been done differently so that the long-term care option would not need to be considered. You can make a HUGE difference in preventing injury at home with your loved one by keeping them moving, active, engaged, and inspired.  If they have recently come home from rehab or the hospital, or completed home care therapy, you MUST keep it going.  Don't let them become complacent and definitely do NOT do too much for them.  If you do this, you are taking away opportunities for all the aspects that they need for further recovery:  mobility, activity, endurance, strength, cognitive challenge and more.    If you are ready for learning a new perspective, my proven 5 step strategy to maximizing someone's quality of life and living your caregiving life without regrets please grab your free training here:  https://www.caregiverbydesign.com/freetrainingWhen you want a tailor-designed approach, a DIY rehab at-home approach, for your loved one, so that you can live a life of freedom and they do too, this is for you: https://www.caregiverbydesign.com/coaching.    You might be just right for this small group coaching series that will launch you into a life of coaching your loved one instead of caregiving all the time.  Get more information at the link and get on the wait list today. Support the show (https://angierischpater.mykajabi.com)

60% of caregivers assist with ADLs - we are going to talk about the area that tends to require the most support today.  LOWER BODY CAREContributing factors:  Limited hip mobilityBack painToo round in frontArthritic fingers and handsPoor visionImmobile anklesSwollen legsPoor sensation of LEParalysisIn most cases, every single one of these barriers can be worked around to allow for a person to be independent with dressing and washing lower extremities. First, look at a few important facts:  Work from easiest to most challenging. For example it's easier to pull loose pants than it is to put fitting pants on that have a button and zipper.       Underwear vs pull-ups    socks vs pantyhose       slide on shoes vs laced Location!   (where are they sitting) The height of the seated surface is very important.  Higher means more reaching but it might be easier to lift the leg to clear the floor for getting it over the foot, however, reaching the foot for a sock is much harderIf you can cross one ankle over the opposite knee you have much more opportunity for successProcess: step back and do more watching, directing and add assistance as needed. Remember that the more you do leads to you doing more.    If your LO can not assist more than lifting a leg while you put the sock on, then my goodness, work with that.  Don't miss an opportunity to use what they have and advance that as much as possible.  If they are limited because they are tight in a joint, take a minute to mobilize that area first.  Work on that area daily to make more progress.   How?     Get help here.   https://www.caregiverbydesign.com/coachingFree video training  "Start living a life without regrets!" https://www.caregiverbydesign.comLower extremity muscle activation is a critical part to overall health.  Don't give up on this too soon.  Even if your LO has hemiplegia or LE paralysis, you have to maintain mobility of the joints to help you and them with basic mobility.    When you stop allowing your LO to use their lower body musculature to do basic ADLs, you are contributing to the overall decline of their lower extremity muscle strength and this leads to mobility limitations and overall health decline.   Pick a day this week during your ADL routine, and look at the clock.  See how much time you are using to help with dressing and what part is taking the longest or is causing your body to work the most.   I would guess that it is with LB care.  Make a goal to shave some time off of this area by starting to involve your LO with it more so you can do something else while they work on it.    OR, by making the task easier for you to do by changing the location, position, and/or approachDo you believe that it's possible?   If you are saying no, I've tried everything;  I want to you pause and really allow yourself room and permission to see things differently. Need help getting started, go to : https://www.caregiverbydesign.com and watch the videoLEAVE A 5 STAR REVIEW FOR THE PODCAST HERE (subscribe and scroll to the bottom.  click on "leave a review" )  https://podcasts.apple.com/us/podcast/caregiver-by-design/id1495740802Support the show (https://angierischpater.mykajabi.com)

Let's talk about the impact of illness or hospitalization on one's health.  I see it happen firsthand as a therapist working in the hospital.  People lose their ability to walk and complete self-care with independence within a very short period of time, making it harder for them to go home without additional support.  Consider this: How at risk are you?  How about your partner, the one you care for?  We are moving less and getting out into nature less as we further develop our society.   Too many hours spent in front of various screens is just 1 example and cause.  RESEARCH article:https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2759840 The objective of therapists like myself is to discharge the patient to a SAFE environment with adequate support.  Over the course of 1-2 weeks, I see patients move from a short-term rehab plan to a home plan when they are able to cooperate in strength, endurance, and self-care skill-building interventions with OT and PT.   When they can't participate (due to medical instability) or they refuse to participate, we see the loss of potential for home discharge The same thing can happen at home with an illness or during home recovery from a hospital discharge, so do everything you can to keep your LO moving with the intention.  Look at what can happen to the body with immobility:  https://www.frontiersin.org/articles/10.3389/fnut.2021.633987/fullAre you seeing this happen with your loved one, either at home or at the hospital, and feeling helpless?   Here is what you can do.  keep them moving and doing as much as they can for themselves so they are always at a starting point of advantage.  Look at what your loved one can do easily.  Any mobility or activity that you see them do like:  sitting up at the side of the bed or without the support of the couch/chair.  Standing up without losing balance, walking, any daily task they do well - have them do that MORE or for longer periods of time than they are currentlyThe HOW: Start a simple movement and exercise program - do it at least once a day https://www.caregiverbydesign.com/seatedexercises (FREE DOWNLOAD VIDEO TO USE)Use the right support items to maximize safe mobility and self-care:   walker, canes, adaptive tools, shower chairs, grab bars, toilet seats/ grab bars, etc CONSISTENTLYGet out of the house, stay social, keep the mind engaged and this includes problem-solving through basic daily tasks.  Let's get you and your partner living the life you actually want by sorting out what your vision for living is, what the boundaries are and how to build strength, mobility, and independence for you both.   https://www.caregiverbydesign.com/coaching Find out more at the link.  I will contact you when we are ready to start.  Support the show (https://angierischpater.mykajabi.com)

Patients have been coming home from the hospital sicker, weaker, and with more complications than you might be prepared to manage at home for a few reasons and the burden on you might be bigger than you expected.  This is a global situation.  What's going on out there?     Covid 19 has overburdened the global healthcare system by adding people requiring treatment to the normal flux of patients Covid 19 has stressed the labor pool of healthcare workers who have to take time off due to exposure, and in some regions of the world, can not work unless they are vaccinated. The lack of available beds in short-term rehab settings and long-term care/nursing homes makes discharging patients from the hospital to such a facility very prolonged.  So, if it is possible to send them home with the support of the caregiver vs staying additional weeks, waiting on placement to STR or LTC, a possibility, then it becomes the planlimited options for some patients (lack of any support at the home and no funds for most facilities) means that there are some patients that end up "boarding" in the hospital until a spot opens up at a facility. This can take weeks to months. What to pay attention to and what to ask about with the consideration of a "home too soon" situation : What are the caregiver's limitations (pain, mobility) and ability?   What is the caregiver's availability and willingness to help with everyday activities? medications: knowing what the new ones are.  What was added or discontinued?  Side effects of medications and interactions.  What to look for if the medication is not working correctly?  community support for you and your partner/LO for the ongoing medical situation that they are dealing with.    Community support for future planning and for financial support.  Positioning and mobility:  safety.  How to assist them in a restorative way. Signs and symptoms of worsening health, flare-ups, reoccurrences.  How to avoid these and what to look for.  You are a vital part of the healthcare system as a caregiver and you should be informed and supported.  That is what I am here for.   I have 2 offers to further help you.  First:   a free video training  "Start living your life without REGRETS!".  start living a life with vision and a plan every day while you help your LO become stronger and more independent  https://www.caregiverbydesign.comJoin a limited group coaching opportunity to help make BIG impact with small changes that put your needs and vision in center focus.  This is geared especially for partners, spouses who are caregivers and want to develop a strong relationship through the present challenge.  https://www.caregiverbydesign.com/coachingSupport the show (https://angierischpater.mykajabi.com)

Seriously,  you can help just about anyone come back from physical decline if you take the right approach and know where to start.  First, consider some of the causes of physical decline: hearing loss, cognition changes, and prolonged inactivity Check out some interesting facts about physical decline at https://www.who.int/news-room/fact-sheets/detail/physical-activityAlso, consider that it takes 3x the amount of time the body was inactive to regain the lost muscle strength so be patient and approach the retraining with care.  I have worked with many bed-bound and deconditioned patients lately and have discovered that just about anyone can make a commendable comeback from serious physical decline, and I am sharing with you how to do it right.     I begin by re-establishing their connection to themselves and their environment.  How??  Ignite the pilot light that is burning within them with oxygen.  Use breath because as long as someone is breathing, they have something to work with.  Waking up the body.  Start moving the core, the limbs, head, and neck.   Move onto isometrics if mobility is limited.  Contracting muscles will increase blood flow, joint stability and help the brain-body connection.   Evidence shows that isometrics are an effective approach to  - improving physical endurance and posture by strengthening and stabilizing the muscles.  Listen to my account ( download the podcast) of a patient that I worked with who went from laying in bed with very little interaction with his environment and very poor social interactions to walking for the first time in weeks by the end of the session. Where to start?   It is absolutely unique to each person.  I always start with the breath.  How well do they control inhale/exhale?  How much exhale power do they have?  This tells me so much.  If they are not breathing with force when needed, it shows a level of weakness that needs to be addressed first.    Work on breathing techniques and move on from there.  Use this simple exercise video to help get just about anyone moving.    https://www.caregiverbydesign.com/getmoving. This is a free video for you to use as many times as you need it.  Check out how you can get even more help right here: https://www.caregiverbydesign.com/waitlistContact me with questions:  https://www.caregiverbydesign.com/contactmeTikTok: @thecaregiverIG: carergive_bydesignSupport the show (https://angierischpater.mykajabi.com)

A follow-up conversation from episode 43.   Taking a deeper look at the strategy needed to build connection through the challenges of caregiving.  After working with a couple the other day, I wanted to share a deeper perspective with you.  Example of a couple working through a basic task that could otherwise cause stress and potential resentment; they discovered how to work together and develop a deeper connection. How could this change your life? Well, consider this: Your Types of strength:PhysicalHealthRelationshipImagine improved strength in any one of those 3 areas.  What does that look like in your life?  What if all 3 areas were stronger.  They are pillars for a well-balanced, healthy, fulfilled life.First: what prevents effective connection?   Take a listen to previous episode 43 “how to build a deeper connection with your partner”  some examples:Poor communicationResentment Loss of hope and visionHistory of arguments, poor outcomesLack of self-insight.  You have to know yourself very well, identify your true emotions and the cause of them, to be an effective communicatorNext: opportunities for connectionco-Developing a plan for living life with a focus on fulfillment.  not just existingBuilding trust that is developed through allowing your partner to try to do more OR to help them in areas that they need help with the way they ask you to ( pause your preconceived ideas, hesitations, expectations and let them lead for this.  Learn together. Remember to be partners)Exercising together or coaching your partner through a program with a specific goalMeal planningCommunity outing/travelSocializing with friendsWhat do you need?Insight  (the capacity to gain an accurate and deep intuitive understanding of a person or thing.)Knowledge (facts, information, and skills acquired by a person through experience or education; the theoretical or practical understanding of a subject.PersistenceSupport the show (https://angierischpater.mykajabi.com)

October is national depression and health screening month: Did you know that 20% of family CG experience it?  That is 2x the rate of the rest of the population! why?October is national depression and health screening month. Did you know that 20% of family CG experience it.  That is 2x the rate of the rest of the population! Some causes: limited socialization, lack of touch, isolation, and stress.    https://screening.mhanational.org/screening-tools/depression/?ref=CANThe one you are caring for may also be experiencing depression and is definitely at risk for experiencing it.  They are more likely to face the risk factors that lead to depression due to life changes they feel out of control of, loss of independence, lack of socialization and getting out of the house with friends or engaging in hobbies, lack of exercise, etc .  1. Impact of isolation: https://www.nature.com/articles/s41598-020-58297-9. Depressive symptoms are associated with less social interaction, being with other depressed people, lacking group interactions, less time with friends. Research shows that social isolation increases the risk for coronary heart disease, stroke, and mortality,  and can negatively influence psychological health leading to depressive symptom 2. Importance of touch in avoiding depression and dealing with depression: FROM ARTICLE https://www.medicalnewstoday.com/articles/touch-starved#complications*affectionate touch promotes psychological well-being. * touch can also reduce the feeling of loneliness *Research also notes that those who report loneliness show dampened cognitive function and a higher chance of experiencing mental health conditions such as anxiety and depression. So, if you aren't around people you probably aren't getting enough physical human contact. Are you getting what your body needs?  Too much cortisol, caused by stress, can cause: AnxietyDepressionDigestive problemsHeadachesMuscle tension and painHeart disease, heart attack, high blood pressure and strokeSleep problemsWeight gainMemory and concentration impairmentOxyctocin is a neurotransmitter that acts like a hormone and it is released that is the counterbalance to cortisol.  And guess what?  It is released most potently with touch.   We were created with the most effective tools to combat stress: skin and the ability to touch.  So what can you do right now to minimize you and your partner's risk for depression:   1. Minimize isolation : Find time to be with people.  Connect in person.  Find time to get out or have friends come over.  Avoid isolation.  This includes while being with your partner.  Use your partner as a source of deep connection.  Make your relationship meaningful beyond your current role.  Serve each other. 2. Touch/interact using affective touch that helps your brain to release oxytocin, the hormone that combats cortisol, the stress hormone.   It is important to seek the help you need to stay healthy, taking care of your mental health needs to be a priority or you will not be able to provide the most effective caregiving.  Talk to your doctor about stress and depression.  Make time every day for your mental health by socializing, getting physical interaction with others, and getting exercise.  Your mental health impacts the rest of your body's functions.  Support the show (https://angierischpater.mykajabi.com)

  First some facts:61% of caregivers are women    1 in 5 Americans       CG face declining health Here are some of the most common challenges faced by partners who are CGing:   ResentmentIsolationDepression (research shows that CG experience at a higher rate than their partners)AnxietyLoss of employmentFailed relationshipFamily strain impacting children and extended familyWhat causes this? Focusing on limitations that face you and your partner vs possibilityLack of transparency with yourself about your feelingsNeglecting your interests, friends, activitiesNeglecting your partner's needs that are beyond those related to health Missed opportunities to provide the support that grows your connectionRole reversalFinancesExercise to try: download a worksheet to help you hereVisualize yourself the way someone else would see you if they watched you for a few hours.  How would they describe you?  What energy do you put off?  (sad, quiet, angry, frustrated, exasperated, chipper, positive, encouraging)   Now, what would you do to help or support this person? What would you offer them?  TAKE NOTE OF YOUR ADVICE, YOUR WORDS TO THIS PERSON.    This is you! You need to care for yourself like this and avoid repeatedly going back to the state that you found this person in.  What can you do to avoid that?  What's causing this problem?   What activities, hobbies, interests would help you to make this connection/bridge to a healthier lifestyle. Repeat this process for your partner.  Look at them as if you are a stranger.  Someone just walked into the house and is meeting your partner for the first time.  What do they see?  How would they describe them?  What advice, support would they offer?   When seeing your partner through a 3rd party perspective: How would tomorrow be, how would it go, if you took time to see your partner in this perspective a few times a day?  What emotions would you feel?   It's likely that you would have more patience and take things less personally.   You might see areas of interest and activity or opportunity that your partner is missing out on that is contributing to the way they interact with you. Last thing:  how do these realizations make you feel and what don't you like about them?    There is more work for you to do here and it doesn't happen overnight.  This is uncomfortable but uncomfortable is good because it means that you are moving out into a new area of growth. Need more help with this exercise:  Check out the option for more support at https://www.caregiverbydesign.com/waitlist to help you to see your partner differently.  Develop a clinical eye that will help you see their strengths and know what to do with them.Support the show (https://angierischpater.mykajabi.com)

Get ready to train your newly recruited caregiving backup with essential skills to build confidence.  Consider these top 6 areas.  Comfort in physical contact: If there are any areas of injury, skin issues, tenderness issues: make these knownIf your LO has preferences about contact make that clearConversational skill and comfort with communications: asking the right questions and reading body language.  If there is a certain way that you ask your LO something or an answer that they typically give you in response to a question you ask, make note of that. Write down topics that your LO easily talks about, interests, TV shows, history Bathroom confidenceShow by example then repeat with demonstration.  Create a timed schedule of use of the bathroom while you are awayHave all areas accessible for different sized peopleMobility confidence / transfersStep by step approach with verbal prompts Maximize your LO participationYou can be the “test” case for them to practice on then repeat this with roles reversed so they can feel itMake avoidance of injury the goal.  This is where injuries often occur ( shoulder, falls)Cooking or meal prep and mealsThe Where, What, and How.  Don't skip any details.  What size are the bites? Do they cut their own?  Do they use special utensils? What snacks (again, where what, and how)Drinks - make them aware of any risks for aspiration.  The obvious is sometimes not obvious to others.  Remember that liquid intake is usually a priority so don't let them forget about this. Exiting the home/car transfersExiting the home should be a priority in case of emergency.  Give them the easiest exit option.  Car transfer should be a goal so they can go places if it is appropriate. Ready for change in your caregiving experience?  Be one of the select students in a small group coaching series that helps you design the lifestyle that focuses on your needs and maximizes your LO strengths and independence.   https://www.caregiverbydesign.com/waitlistSupport the show (https://angierischpater.mykajabi.com)

Finding a backup caregiver so you can get some time for yourself is essential but takes some planning.  You might be thinking, "Finding the perfect caregiver would be a great luxury."   This is not true. First let's look at what the benefits are: Exposure to different people and experiences for your LOTime for you to spend doing whatever you need to do that adds value to your lifeSafe and planned dry runs in the case of an emergency need for help/backupBuilding confidence for the person you hire to one day help someone else or apply this to their own LO when neededHaving a person to call when you need a 2 person approach for moving your LO in the case of an emergency.Things to consider when selecting someone?   Your LO personality   ( be honest about their strengths and weaknesses) Do they need extra energy brought into the room or does that cause them anxiety? This caregiver does not have to interact just like you.  The backup may be a nice change of pace for your LO so don't take offense.  Think about how you engage with other people.  You might enjoy being around people that are very different from your spouse What are the absolute musts that the CG will need to be able to do for your day away?If it is an option for your LO to get out with someone else, that is a great option too.  Consider dropping them off at a location and then starting your outing/experience from there. Watch what you do as from a third party perspective. Write down the flow of the day and times that you do things.  It doesn't have to be exact but it is easier to do this as the day is going on, in live time, than it is to sit and try to draw it all up from memoryLeave your expectations for perfection at the door.  Make one absolute expectation be for no injuries and for fun.  Meet the objections your LO might express upfront:  Your LO objections might be related to - nervousness, control, antisocial behavior.   Try this approach:Listen to them.  Let them talk to you, share their thoughts. Don't interrupt.Understand and repeat what you heard as an active listener.Respond calm, genuine feedback that validates their concernConfirm the plan you are establishing again in a positive light Selecting a caregiver without initial skills in caregiving is okay as long as they have a heart of service and you feel comfortable with them ( although a Google search of their name isn't a bad idea either).   register for live workshop prior to July 29, 2021 https://wwwcaregiverbydesign.com/workshop and learn how to find freedom Join me on FB: https://www.facebook.com/caregiverbydesignLeave a review on apple itunes: Support the show (https://angierischpater.mykajabi.com)

Buying, building, and remodeling a home is a huge undertaking for anyone but the challenge is real when you are in need of making it suitable for your aging parents, your spouse with a chronic illness or physical challenge, or if your planning for your own future.  There is a growing trend toward people aging in place, coming home from hospitals sooner, and with more significant challenges in terms of illness or physical limitations. This trend will be growing as we progress through time.  You may be facing this challenge right now? I would love to hear more specifically about it and you can send me your story, your challenges to my website https://www.caregiverbydesign.com/contactme or DM me on IG https://www.instagram.com/caregive_bydesign or FB https://www.facebook.com/caregiverbydesignI have been in many many homes that were very challenging for people to navigate with their newly compromised LO and they were scrambling at the last minute to make changes. Sometimes, when the hospital would call and say, "your mom is coming home today?” The CG is often a bit frazzled with last-minute changes to be made.Matt, my husband, and architect answered some questions for us : Q: What are some of the biggest mistakes made or missed opportunities when people are modifying a home for an aging or disabled family member? A: 1. Overcomplicating the widening of doorways.   2. Using cheaper materials or taking shortcuts suggested by the contractor.                                 3. Not contacting the building inspector in your area for the clearances you may needThings to consider : seek a local home modification specialist.  Consider making quality improvements that have a longevity factor.  Consider asking an architect to do a consultation for your situation.   Allocate your money to the most used parts of the home.Q: When looking at a new home build, what are some things to consider?   A: Be aware of the updated international residential building code.  For example: you no longer need to have a 6" step from garage to home entry. A:  consider future use and placement of an elevator in a 2 story home.  It's not as much of a luxury as you might think.  it is more possible than it once was. A: consider the use of a kitchen that allows your LO to use it, socially at leastA:  make kitchen mobility as safe as possible, consider railingA:  more space, less clutter, is very valuableA: Bathrooms with built-in railing .  The layout that would accomodate a wheelchair. Standard bathroom is 5 feet by 7 feet deep.  Consider making this more spacious.  Layout is very important.  Consider making a bathroom connected to the bedroom for them to minimize fall risks. A: you could have a home designed so that the entire floor could be gutted and be left with supporting structure that would allow for changes you will need in the future.  A: Consider laying out bathrooms with room for vertical grab bars A: Flooring is an important investment and carpet is not ideal. A: think carefully about entry and exit access for someone in a wheelchairSubscribe and leave a review on apple iTunes and share with your caregiving friends and family. Support the show (https://angierischpater.mykajabi.com)

We all have self limiting beliefs but those of us who are aware of ours and work to minimize the power they have on our interactions with the world are winning.   What is a self-limiting belief: assumptions or perceptions you have about yourself, your abilities, that are often subconscious yet have the power to alter your performance day to dayHow does your self-limiting belief get in the way of making progress toward more freedom and joy in your life?  What is your self-limiting belief about caregiving for your loved one?Example:  you're the caregiving wife of someone with a physical limitation acquired and you are finding that as time goes by, you are taking on more and more of a “to-do list” and those things are getting more difficult        Your self-limiting belief may be - “There must be something wrong with me since I feel so edgy through the day and exhausted.”Example: you're caregiving for your parent or grandparent  Your self-limiting belief might be - “it's just me, doing everything, and I can't do anything different.” or “If I had more help, they would be doing better”    “ Someone else could juggle this better than me” Why is it important to recognize this and what to do with it.   Calling them out gives you the power to control them and minimize their impact on your emotions and interactions Consider journaling or voice recording into your phone Knowing the limiting belief will help you understand why you are struggling with certain emotions which could be contributing to stress and fatigueOnce you recognize your own self-limiting beliefs, you can help your LO to do the same and this helps you to ID why they may be stuck in certain areas of their cooperation, participation, engagement.     Imagine what helping them get unstuck could do.  As an OT , this is something that I would work through with my patients when I found that they lacked the initiation or perseverance to work towards their goals or if they didn't have any goals and told me that they “had no purpose” and wanted to give up.   There are stories that they are telling themselves, beliefs about themselves that limit their progress, or their ability to even see a different path forward.      Unlocking this limiting belief is important and makes a big difference in how you and your loved one experience life.  This applies to all people but I know that you, a caregiver, are facing excessively challenging situations day to day.  Your loved one is also experiencing challenges that they may not be able to express and it is important to recognize this and help them to gain some control over how it impacts their life.  For more help with shifting your mindset and finding more joy and confidence in your caregiving -  https://www.caregiverbydesign.com/freetrainingWant to hear more about a specific topic - https://www.caregiverbydesign.com/contactmeSupport the show (https://angierischpater.mykajabi.com)

These are not in order of importance but here is a quick reference list of the Top 10 preventative approaches to caregiving that you can take right now and see a difference.  Optimize nutrition and hydrationOptimize activity in the home/participation in ADL and IADL if ableAnalyze and improve quality of movement  with a daily routineSet medications up for ideal times for best effectiveness and consistency ( talk with your MD nurse)Engage in socializations to increase: cognitive activity, visual, verbal, muscle Get the home modifications you need ( bars, rails, toilet seat, shower seat, lighting in the home day and night)Get a toilet with a self-cleaning feature if they have difficulty with wiping ( UTI, skin breakdown)Adjust flooring in the home (carpets, flush thresholds, steps) to prevent falls Establish what walking device they should be using and keep them consistent with itAnalyze bed mobility safety and safety getting to and from the bedroom to the bathroomYou might notice that these all promote independence in some way.  This should be the goal that you don't give up on because the more independence that your loved one has, the more independence you have.  Want to be a beta tester of my upcoming membership for free?   go here and let me know your situation and I will send you more information.  I would love to get your feedback before I launch this to the general public for a monthly fee. https://caregiverbydesign.com/membershipTake part in a 3 day free training series that gives you the tools and strategies to minimize your caregiving stress https://www.caregiverbydesign.com/freetrainingSupport the show (https://angierischpater.mykajabi.com)

Caregivers are a vital part of a nation, a societies, infrastructure and there a few reasons why.  First, let's define Infrastructure : the basic physical and organizational structures and facilities (e.g. buildings, roads, power supplies) needed for the operation of a society or enterprise.First, some facts to consider: The average cost of a 3 day hospital stay is 30KER on average charge about $2300 per visitAverage ALF monthly cost is 4KAverage nursing home monthly cost is about $8KAverage in-home care with an average of 44 hrs a week - the 2020 numbers show about $4400.Average hourly pay for caregiver $12-15 All of these numbers are very out of reach for most families.  Most, 80% of the help provided in the home, is provided by unpaid family and friends.  This lends to caregiver fatigue, stress, depression and a serious strain on their economic situation as most of them eventually leave their jobs or work less hours in order to provide care.   This often results in the gradual seeking of a higher level of care that usually starts with Assisted Living Facilities.  Insiders tip ( there may not be as much assistance provided in assisted living as you were hoping for) .  These facilities require very mobile and mostly independent residents and they are not usually able to assist with daily tasks such as dressing, that the family and resident assume will be provided. Ex: Usually, the resident must be independently mobile throughout the necessary spaces of the environment. Here is a list of things to consider: caregivers are a very important part of the infrastructure that this country needs to progress. Without them, the ALF and nursing homes would be overloaded and they are already short-staffedGood caregiving minimizes hospitalizations and ER visitsCaregivers are a vital part of preventative healthcare and should be recognized as suchA caregiver that is paid for their role is able to continue contributing to the economyA paid in-home caregiver would be able to participate in society/economy with the one they are caring for which further adds to their well being, mobility, social skillsCaregivers organize the healthcare ( MD visits, meds ) which helps to minimize healthcare error   In the US there is a current bill (the American Jobs Plan) that is being discussed by the Republican and Democratic parties that is looking at the importance of caregivers as part of the infrastructure of this nation and how to support them.  This includes caregivers of children but the president has specifically mentioned the need to support efforts to keep the aging population supported if they desire to remain in their homes.   This is a move that is a long time coming and needs to be taken more seriously by the citizens.  I'd be so interested to hear your situation, your story.  Would you consider sending me a short email ?   caregiverbydesign.com/contactmetake advantage of a free training to help you minimize stress and be therapeutic https://www.caregiverbydesign.com/freetrainingSupport the show (https://angierischpater.mykajabi.com)

Do you know what's going on in the therapy community?    They are tired of the insurance game, the productivity expectations of their employer, and they are feeling the push toward finding a new career.  Many are actively looking for ways to find a way out of even high-paying jobs.   I am a perfect example.What does this mean for you and your loved one? if they are to be placed into STR or LTC you will be seeing this strain.  You may see a different type of “rehab” than you expected.  In combination with the effects of the pandemic on the rehab industry in these settings, the growing burnout rate among therapists is another wave of change that can't be ignored.  You may have an opportunity to maximize your loved ones' well-being right now at home.  Don't wait for something to happen.  A fall, UTI that causes a decline in mobility, a stroke, worsened CHF or COPD, Diabetic complications.  These are the things that cause many otherwise unsuspecting individuals to enter an extended care facility like STR or even LTCLet's start working toward preventative medicine at home.  How?  First, you have to believe that you have the power to make an enormous change and that doesn't mean you DO MORE.  In fact, in means, you do less. You need to make room for the one you are caring for to do what they can do to the best of their ability.  Ready to shift focus? Let's start with imagining your day.   How you feel right now.  Are you listening to this with a burned-out spirit?  Are you approaching it?  Do you dread proceeding through the day?  Maybe not but perhaps you can feel it creeping in.  I am going to tell you an insider to the healthcare industry secret.  When we begin to perform our roles with less connection, less purpose, and we are asked to see more and more patients; we rush and we begin to feel the beginning of burnout.  Healthcare workers can move onto a different job.  They can leave behind the thing that is exhausting them.  You can not.  But, you CAN modify it.  So, you need to find a way to begin doing your caregiving differently.  I've said it before but here it is again, I know without a doubt that every caregiver has the full potential to be as effective as a certified clinician in developing strength, mobility, social and cognitive growth.  What does it take?  Knowing your personal goal/vision for yourself.  Your daily routine.  How you feel.Knowing what your client/ loved one's strengths are and how to use them.  How to build on those strengths while maintaining them as used in your daily routine.  Knowing your barriers: (environmental, social, physical, economic, mental) you must know what is getting in the way of your loved one making progress.  There may be several.  Why?  If you don't know what they are they will grow like a weed and take over your garden that you are so carefully trying to maintain balance in. Finding a daily routine that puts all of these things together in a way that puts your vision ( go back to the beginning) first and your client/ loved ones' abilities and potential right next to that.  You need to be a partner with your loved one, not just a service provider/ caregiver.  You need to think of them as your partner with whom you will work to achieve a goal.    Talk to them about a goal.  Get help here: http://caregiverbydesign.com/vision3 part video training to help : https://www.caregiverbydesign.com/freetrainingSupport the show (https://angierischpater.mykajabi.com)

Poor balance or declining balance is directly impacted by vision.  If there is a deficit, you can be sure to see changes in balance.    3 systems that impact balance:VisualProprioceptive Vestibular  So imagine how low vision impacts this.  Imagine yourself walking in a dark space.  Many older adults are impaired by low vision and it is not even known.  Sometimes, it declines or changes before it is caught by the eye exam.  Any deficit in joint and muscle feedback is going to minimize the amount of information that is given to the brain to establish balance.   The visual and proprioceptive combo is especially important if someone has any type of vertigo.   Vertigo can come and go and the person experiencing it needs to use the other supporting systems to compensate. When there is dysfunction in the vestibular system, the brain is working extra hard to keep the body upright and this can impact the brain's ability to spend energy on other things like memory, problem-solving, sequencing. Impacts of low vision.  Poor depth perceptionPoor peripheral visionSlow movementObjects appearing to bounceSensitivity to light Difficulty reading labels or print of any kind vision therapy:  This therapy works to balance out the visual system first and when it is working better, they incorporate vestibular work.  This connects the 2 systems to build the foundation needed for balance.Also, consider an evaluation from a Neuro-optometrist who will complete an eye exam on a whole new level.  Beyond checking visual acuity but evaluating how the eyes are working together, their focus ability, scanning and tracking, periphery and visual perception.   Immediate changes you can provide to an environment to compensate for low vision: Lighting - more is better.  Night lighting too.   Track lighting along the floor (like the movie theater)Use of red tape on corners hallways, door frames, and on steps or changes in floor heightPut that same tape over the light switch plate on the wall to increase its perception/locationAvoid busy floor patterns on carpets or tileAdd railings and handholds Use contrasting dishes and utensils and cupsBathroom magnification mirrorCloset lighting Contrast furniture from space using pillows or throws that are easily identifiable.  this makes it easier for the eye to find them in space.  Clothing:   use a red permanent marker on the inside label to help ID back from the front.  Next steps:  talk to your MD about a neuro-optometrist if necessary.  With the evaluation, get vision exercises to work on at home.   You can request an OT specializing in low vision too.   Be a Membership Beta tester ( go through the core modules for free and give me your feedback) Tell me what you want to hear an episode on:  https://www.caregiverbydesign.com/contactmeTake advantage of a 3 part video training to minimize your stress and maximize your freedom: https://www.caregiverbydesign.com/freetrainingWebsite with more information: https://www.caregiverbydesign.com/Support the show (https://angierischpater.mykajabi.com)

Your touch has the ability to lower heart rate, minimize inflammation, increase serotonin levels and help make a connection even when that seems near impossible.  Our skin is the largest organ of our body and you can make a big impact with purposeful connection between you and your loved one's skin.  When was the last time you felt a connection from touch?  Thinking about the impact that you can have by using your hands with a therapeutic intention might seem like a stretch for you but I guarantee you that it is not.  I walk you through how to use your hands to connect and bring restoration of rest and promote wellness for the one you care for.  Listen to a true story of how I was able to connect with someone I was working with who was experiencing hallucinations and was otherwise completely disconnected from his physical and social environment.  We made a connection that had lasting impacts on he and his wife, in just 5 minutes and so can you.   When our skin processes touch, the same areas of the brain that process decision-making and memory are activated.  If those are deficit areas with the one you care for and you can activate them with the simple use of your hands, why not give it a try.   here is the thing that you must know first.  You have to find inner peace and calm first.  Connecting with your own sense of wellbeing is a must.  Don't worry because I walk you through how to get started. Tell me what you need to know more about to help minimize your stress and improve your effectiveness:  Go to:  caregiverbydesign.com/contactmeI'm looking for beta testers of a membership program that I have created for caregivers.  Totally free !  I need your insight and feedback so that I can help people like you to provide care with less stress and with a therapeutic effect Please contact me : caregiverbydesign.com/contactmeHere are the links to the articles that are referenced:  https://academic.oup.com/cercor/article/10/3/295/449599?"Here we focus only on the role of the orbitofrontal cortex in decision making and emotional processing, and the relationship between emotion, decision making and other cognitive functions of the frontal lobe, namely working memory"https://www.wired.co.uk/article/the-good-life-human-touch"Warm, friendly patterns of touch also calm down the recipient's neurophysiology of stress. In one study, simply holding the hand of a loved one deactivated stress-related regions of the brain when anticipating going through a stressful experience.https://www.the-well.com/editorial/the-healing-power-of-touchSomething else happens when another person touches you: Your levels of serotonin — a neurotransmitter that basically acts as the body's natural antidepressant and pain reliever — increase, says Field, who has studied this touch response and published her findings.Support the show (https://angierischpater.mykajabi.com)

Eating right can be a challenge at any age but we all know that the aging process and any recovery from illness makes this more challenging and it can be detrimental.  In a previous episode, I discussed how the sole source of energy for our bodies is what we put into it - food. https://www.buzzsprout.com/807851/episodes/8093466   Eating and drinking the right quantities at the right times and with the right ingredients can make a sluggish person transform into one that is more motivated to move and participate in the daily routine.  Imagine what that would mean for you and your loved one.  Podcast guest, Leslie, a registered dietician, provides simple suggestions for getting started with the right nutrition and hydration choices.  We discuss how small but consistent changes in one's diet can impact their function and have a general impact on their health.   Don't be intimidated by not knowing where to start if you currently find yourself battling the "I don't want to eat now" position of your loved one.  Small snacks that are packed with power can be very effective.  Increasing hydration is another challenge that can be met with flavor options and be increased over time.  Check out this link for a multitude of tips on nutrition and to find a registered dietician that could help you on your journey https://www.eatright.org/If you want more support in your caregiving skill application and you are a heart centered service provider, I invite you to a free mini training series that I created.  https://www.caregiverbydesign.com/freetrainingWant to hear something specific covered on this podcast?  Well, I want to provide an episode just for you so please let me know what it is right here: https://www.caregiverbydesign.com/contactme**disclaimer:   This Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition.  NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE HEARD ON THIS PODCAST. Support the show (https://angierischpater.mykajabi.com)

Have you heard of the sandwich generation?  You might be in it and not realize you are a part of a large and growing community nation wide that is experiencing a new kind of challenge. Caregivers are finding themselves in a sandwiched situation between taking care of their immediate families and also providing care to their aging parents or grandparents.  Life becomes more challenging than one expected when this situation arises and special attention to you take care of yourself ( body, mind and spirit) is very important.  Pat is a life coach specializing in helping families find healing in their grief.   She shares with us her strategies for keeping the caregiver in a healthy mindset and lifestyle while moving through the journey of a sandwiched generation.   Taking care of yourself begins with knowing where to start and how to be successful by taking small but consistent steps toward BALANCE, using her unique B.A.L.A.N.C.E. program.  You will want to hear about this from Pat in this podcast episode and check out the free ebook so you can work through your unique process. Free training offer from me: https://www.caregiverbydesign.com/freetrainingcontact Pat Sheveland and see what she offers:  https://www.healingfamilygrief.com/A free ebook for you from Pat Sheveland:  https://www.amazon.com/Living-Life-Middle-Caregivers-Multigenerational/dp/B08QRXSRRHThe Via survey of character : https://www.authentichappines.sas.upenn.edu/testcenterContact me with comments or suggestions for future podcasts at : https://caregiverbydesign.com/contactmePat's Free ebook https://patricia-sheveland.mykajabi.com/free-bookSupport the show (https://angierischpater.mykajabi.com)

Speaking from experience, from the perspective of a woman, a girlfriend and wife to her husband, I am sharing some strategies to keep the chemistry connection while being a caregiver to your partner.  I am not a relationship coach or marriage counselor but I have experience in this department and I want to share with you from my heart what has worked for me.If you are a wife or partner and a caregiver, I know you have experienced the shift in the connection and sometimes it gets lost all together.  Whatever your circumstance, I want to encourage you to focus on keeping the chemistry between you and your partner alive if you are in a healthy relationship.  However, if you are being mistreated and you are unsafe, these strategies are not intended to repair that situation and I urge you seek help.  Caregiving can draw away your energy and change your relationship with your partner and although their are elements of your relationship that may never be the same, there is no reason that you should give up on connecting in an intimate and fulfilling way with your partner.    Even when sexual relations may be an impossibility, you can still connect with these strategies that will provide you with the sense of belonging and desire that you seek. avoid arguing about how to do something.avoid emasculating with your words and actionsoptimize independence by removing barriersuse of your body language, touch, snugglingeye contact with a deeper messageactivities that he enjoys do what you need for energizing your body, mind and spirit every daybecome aware of your body language , tension, approachability and learn to find relaxed state through a routine of physical, mental, emotional activityTake time for yourself every single day even if it is 10 minutes but you must find a way to increase your energy level from within.  Energy levels seem to have a direct relationship on mood.  Mood has a direct relationship on behavior and behavior has a direct relationship on relationships.  So, you have to start with finding and connecting to the energy sources that you need every single day.  Feeling good about your body and mind are the most important thing you can do for yourself.    Future guest Pat Moffett link: https://icecreaminthecupboard.com/Contact me with questions or comments. what would you like to hear on the podcast?https://www.caregiverbydesign.com/contactmeReady for a little more?  Here is your free 3 part video training to make your life a little easier  https://www.caregiverbydesign.com/freetrainingSupport the show (https://angierischpater.mykajabi.com)

Have you stopped to consider the impact of a low energy body on your role in caregiving?  We  are talking about both your energy levels and your loved ones.  Energy levels impact the sound quality of someone's voice, their posture, their movement, their interaction with the environment; and a low energy body can make all areas of daily living  more difficult.  Energy is required to initiate a task, sustain participation in a task and complete a task.  Energy is required to ignite the thought that will precede the initiation of the task.  Where does this energy come from?  Have you been wondering why your loved one seems to be lacking energy and maybe it is declining steadily and so is their participation in daily tasks?  Consider the definition of energy first.  Energy is defined as the ability to do work.  what is the work of your Loved one?  It could be as basic as sitting up at the side of the bed each day. Energy  is created by the food we eat.  So, consider what your loved one is or isn't eating.  How often are they eating?  When energy levels are very low, it can be a challenge to get a person to even engage in the vital necessity of eating.   If this is the case, consider providing small snacks that are carbohydrate based to add some fuel to the body in order for them to have the energy to eat more substantial intake ( consult with your physician for all diet needs).  Consider tasks that require more energy ( showering, dressing, leaving the house) and plan food intake around this for optimal participation. How is energy released?  This involves breathing.  What is the quality of breath in your loved one?  Watch how deeply they breathe and exhale. This is a huge factor because oxygen is required to break down the sugar in the blood and the body releases it at CO2.  Proper oxygen levels aid in this process and if it is lacking you can imagine the delay in this entire process.  Too much CO2 in the blood stream can cause hypercapnia, although this is uncommon; it provides insight to the importance of proper breathing.  Over the years, working with hundreds of adults, one of the simplest exercises to get them started toward increased energy level and core strength is with breathing and core activation.  I made a video just for you to help you engage them in these and it's right here: https://www.caregiverbydesign.com/seatedexercisesSo, if you are feeling like your role as a caregiver just keeps demanding more of your physical body and you are seeing less participation from your LOs body, this could be one of your foundational issues that you can start to address today.   If you want more support in your caregiving skill application and you are a heart centered service provider, I invite you to a free mini training series that I created.  https://www.caregiverbydesign.com/freetrainingWant to hear something specific covered on this podcast?  Well, I want to provide an episode just for you so please let me know what it is right here: https://www.caregiverbydesign.com/contactmeSupport the show (https://angierischpater.mykajabi.com)

Pick a challenging area of your caregiving day.  You know, that time of day that you feel stuck or when your loved one just doesn't participate at the level they need to.  What if your unique personality traits could be used to help you through those and  make it a little less frustrating?  There is a term that health care providers know as  'therapeutic use of self' which is defined as the 'thoughtful and deliberate use of one's personality, opinions, and judgments as a component of the therapeutic process', according to Mosby's Medical Dictionary (2009).   Just think about this as it applies to  an area of your day in caregiving and in your regard to your interactions with your loved one.  If you interjected a therapeutic level of listening and use of your insights with your unique personality traits; you can experience a very different interaction.  I am not suggesting that you apply therapeutic use of self all through your caregiving day because that would be so exhausting.  You start with just one area and apply it each day.  I invite you to take a personal challenge of applying this idea to one area of your caregiving day, starting tomorrow.  Be consistent about your application for 5 days in this one area.  Consider video taping the task or interaction on day 1 and then again on day 5.  Set a goal that you would like to achieve.  It could be to have less tension between you and your loved one, to have more participation, to accomplish the task with less strain.  Whatever it is that creates a challenge to you and your loved one; the goal should be to minimize it with the application of therapeutic use of self.  As you practice this application of your personality in one area/activity of your day, you will experience an ease to it.  As an OT that has used this tool as part of my practice for 20 years, it is something that happens without me thinking about it.  This can happen for you to.  The use of this approach has these benefits: builds trust,  increases participation,  increases positive interactions, Another benefit of using "therapeutic use of self" is how it helps you to maintain your relationship with your loved one if you are a wife or partner for example.  Caregiving throughout the day can cause a dilution of your deeper relationship, whether that is intimate, spiritual,  companionship and nurturing.  You can't allow the caregiver role to blur all the other lines that create your relationship.  This applies to you if you a caregiver to an adult child, sibling, best friend or other relative.  If you want to maintain your relationship it may benefit you to begin compartmentalizing your role and applying yourself therapeutically at times throughout the day and reserving yourself on a non caregiver role to maintain your relationship levels in other areas.  FB page for listener https://www.facebook.com/caregiverbydesign free 3 part video training series  https://www.caregiverbydesign.com/trainingseries 6 week personal training series with me https://www.caregiverbydesign.com/6-week-trainingSubscribe to this podcast so you don't miss another episode. Let me know what you want to here more about.  What do you want a podcast dedicated to?https://www.caregiverbydesign.com/contactmeSupport the show (https://angierischpater.mykajabi.com)

The daily routine of a caregiver includes focus on many of the same things that an OT is looking at when they work with a patient .  The difference is in how those things are analyzed and how they are interpreted.  Attending to the person with a holistic approach that carefully considers main areasbody function ( think of all the ways the body interacts with the environment) and body structures ( think of all the things that keep a body alive), values, beliefs and spirituality.habits, daily routine, role in the home or social structure,  behavior patternsphysical and social envrionments, culutre, activity demandsHow they perform - the motor, sensory, emotional, cognitive, communication and socialWhen you are able to analyze the details of how your loved one is engaging in their environment and their daily life; you will see the deficits and strengths.  Understanding these are very important in the effort to improve any areas of decline or stagnancy.  The wellness and quality of life that you and your loved one deserve and desire begins with identifying what is between them and their "better" version of living.  Learning how to maximize your therapeutic use of your own personality and unique gifts will make a world of difference for you and the one you care for.   Making daily changes in your approaches to caregiving will help you live a less stressful experience and it will directly impact your loved one by promoting greater wellness, independence and quality of life.  An OT aims to promote independence with wellness and quality of life at the highest level of importance.  As a caregiver, you are probably aiming to do the same.  You have the potential to become a therapeutic caregiver by learning some very basic strategies and skills.  I invite you to check out a free 3 part video training series  to help you start thinking about things a little differently:  https://www.caregiverbydesign.com/training-seriesDo you already know you want to jump on a fast track to becoming a therapeutic caregiver? You can enroll in a 6 week personal training series with me.  Click here for more information https://www.caregiverbydesign.com/6-week-trainingSubscribe to this podcast so you don't miss another episode.  Let me know what you want to here more about.  What do you want a podcast dedicated to? https://www.caregiverbydesign.com/contact-meSupport the show (https://angierischpater.mykajabi.com)

What the heck is OT anyway?  The definition is long and sure does encompass a litany of focus areas that bring well being and quality of life to the forefront.  When listening to this episode of the podcast, you will see how similar your role as a caregiver is to what an OT does.  Without the advantage of the collegiate degree that OT's pursue, you are providing a service to the one(s) you care for that looks a lot like what an OT does.   I truly believe that caregivers hold the power to be as effective as a clinician with the right approaches used consistently over time on a daily basis.  You can do that right? This is part one of a 2 part series that goes over what OT is all about and how you can be more effective in your caregiving while improving your own well being and quality of life by adapting the mindset of OT.  Here are the basic areas discussed in this episode: occupation means the art or act of "doing" or being engaged in a taskpromotion of health and wellness addressing the risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perceptual, and other aspects of performance in a variety of contexts and environments to support engagement in occupations that affect physical and mental health, well-being, and quality of life. activities of daily living (ADL), instrumental activities of daily living (IADL), The overlap between OT and caregiver is wide and there is so much to be gained in the journey of a caregiver by adopting a mindset along the OT focus areas.   I encourage you to make a visual list of the characteristics addressed by OT ( listed above)  of the one you care for and another column describing yourself.  Your well being and quality of life are vitally important and must be put at the top of the list.  You have to be a priority.  Here is a tool to help you develop the OT mindset and shift the trajectory of your caregiving journey .  A 3 part video training series, one video per day for 3 days, will give you a jump start on making the transition you and your loved one need. https://www.caregiverbydesign.com/training-seriesLet me know what you need to know more about to make your caregiving journey less stressful https://www.caregiverbydesign.com/Free delivery from instacart  on your first order with this link:https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources:https://www.caregiverbydesign.com/Support the show (https://angierischpater.mykajabi.com)

Wondering when it's time to get your loved one OT or PT?  There are some major signs that you want to be looking out for as you care for your loved one.  You might even want to take notes or journal a few changes that you notice because this can help the physician to get a better idea of what is happening and when it started.  Here are a few things to watch for: falling: either frequency increasing or the very first time.  You don't need to request therapy right away but you should let the physician know so that it can be in the record and over time, they can track back the start of signs and symptoms of something more sinister.   Shortness of breath : during familiar activities or with new attempts of activity.  New levels of shortness of breath or increased fatigue with sudden onsetgeneral decline in mobility or engagement in activity due to weakness, increasing pain patternsincreasing dependency on you or others for assistance with routine tasksYou need a referral from the physician for physical therapy or occupational therapy.  Home based vs outpatient therapy will need to be considered.   Following an assessment, a plan will be developed and this can help you as a caregiver with your role too.  Don't be shy in asking for suggestions on your challenges in providing care.The difference between OT and PT?  This is a common question.  In a really generalized nut shell, this is how I explain it to patients when they ask me.  PT is focused on restoring and improving muscle activity for walking and other functional movements.  They focus on balance and ambulation quality and safety as well as pain management through the development of strengthening and/or stretching exercises.  OT uses a holistic approach to focus on maximizing one's independence in daily life routine with consideration of whatever challenge their body is presenting with the use of modifications,  exercises and environmental changes.    Again, this is very basic.  However, the need for both OT and PT is often needed and we work well together to make the patient as successful as possible in the shortest amount of time.  I want to offer you the option to receive a 3 part video training series that will help you to develop a therapeutic approach to your caregiving and lead to a less stressful, more rewarding, well balanced lifestyle as a caregiver.  Check out this link for more information:https://www.caregiverbydesign.com/training-series Let me know what you need to know more about to make your caregiving journey less stressful https://www.caregiverbydesign.com/Free delivery from instacart  on your first order with this link:https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources:https://www.caregiverbydesign.com/FREE  exercises to help get the body movinghttps://www.caregiverbydesign.com/seatedexercisesSupport the show (https://angierischpater.mykajabi.com)

If you haven't taken the time, as a caregiver, to realize what you want your caregiving journey to look like; today is the day.   Join me as I help you to work through the thought process to develop a vision.  First, I remind you about the # 1 thing that you need to know.  You are probably doing too much.  Why? It might be because you have no clear vision of how you want this caregiving thing to go.  You are just rolling with the punches right?  Your trying to be the best caregiver you can and support your loved one in every way.  You don't have much support from the outside.  Each day you go through a routine and over time you are doing more and more than you did a week or a month ago.  Do you believe that it doesn't have to be that way.? You might be asking "How could it go any differently? " You have to have a goal for yourself as a caregiver.  Start by asking yourself:   What do you want your max effort/ work load to be in any one area in the next month?  You need to have a clear goal that comes from a vision of what you want your caregiving life to look like.  It's okay to be creative here.    TAKES SOME NOTES HERE AND BE HONEST;  What do you want your role as a caregiver to look like (think  in terms of  %s)  how much time are you devoting to yourself?  What personal activities do you want to participate in?  How much free time do you want?  ( be specific - in minutes/hours)What time of day is most important to you for personal time?  What professional goals do you have, if any? What are  your family or friend goals? What activities do you want to do with your loved one? What is the one thing that really drives you a little nuts every day?What makes you anxious?If there were just one thing you didn't ever have to do again (in your caregiving role)  what would it be?Download your worksheet here.  Don't be shy.  It will help you move forward.https://www.caregiverbydesign.com/your-vision-your-goalsTrust me, it's worth the time.  Creating a vision is a challenge, especially when you have been in a repetitive cycle or feel trapped or stuck.  I hope you take the time to explore your thoughts and create a vision and a goal for yourself.  This will help you and your loved one/ one you care for.   Let me know what you need to know more about to make your caregiving journey less stressful https://www.caregiverbydesign.com/Free delivery from instacart  on your first order with this link:https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources:https://www.caregiverbydesign.com/FREE  exercises to help get the body movinghttps://www.caregiverbydesign.com/seatedexercisesaccess visual training and leave a commenthttps://www.facebook.com/caregiverbydesignSupport the show (https://angierischpater.mykajabi.com)

Just getting to your physician appointment can be overwhelming right?  By the time you are in there face to face you might miss an opportunity to bring up some important information.  These are often overlooked and can provide very helpful information on multiple levels.       1.   voiding the bladder- what should be expected?  What is the typical amount per day and volume?If they are on a diuretic, this is especially important to know.  They should be eliminating the desired amount depending on the dose of their medication and the timing of that medication.How much fluid should they consume daily to eliminate the right amount of urine?      2.  Medication timing and optimal pairing with other medications what would be the best time of day to take a medication in relation to the others on the list?  When is it most effective?  Could some of the challenges or questionable areas you see occurring with your loved one be related to a medication?  Don't hesitate to take note of these and ask about them.           3.  Skin  and hygiene issuesslow healing areas on the skinareas between toes and on feetnail careareas at risk for pressure soresskin areas around genitalia Asking the right questions could give you the information you need to make your caregiving experience more effective and directly impact your loved one's daily function.  It is often the most basic things that we forget to ask our physicians for advice about.  Let me know what you need to know more about to make your caregiving journey less stressful https://www.caregiverbydesign.com/Free delivery from instacart  on your first order with this link:https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources:https://www.caregiverbydesign.com/FREE  exercises to help get the body movinghttps://www.caregiverbydesign.com/seatedexercisesaccess visual training and leave a commenthttps://www.facebook.com/caregiverbydesignSupport the show (https://angierischpater.mykajabi.com)

Are you as excited as I am to put 2020 behind you? 2020 brought a whole new level of stress and isolation to caregivers.   Many people became caregivers in 2020 because they brought their loved ones home from hospitals instead of sending them to nursing homes or alternative care settings.  Maybe you have encountered challenges that made you stronger but you want 2021 to be better.   What would you like your 2021 to look like?  I am not talking about New Years resolutions here.  I am talking about how to set obtainable goals that will help you achieve a less stressful caregiving experience and your loved one to get some of their life back.   It is possible with the right vision and approach.  First you have to ask the right questions.   Starting with this: "What do you miss doing the most?"   The answer to this question will give you insight to your loved ones source of energy and joy.  Whether it is an activity that seems impossible to return to or one that seems too basic to matter, this is your first step.  Knowing this will serve as your foundation to encourage more activity that they miss.  Get them visualizing it again and feeling the comfort of the memory. "What stopped you from doing this?  What got in the way?"   There are a few possible factors that you need to identify: Physical (weakness, pain, lack of access, transportation)   Emotional ( fear, avoidance, guilt, worry)Analyze the task / activity that they have shared with you.  What is required for them to participate in it?  Write down all the aspects as you brainstorm this.  You will need to develop a clinical eye to see their limitations physically.  set an obtainable goal for the closest possible activity that they could perform.  Make it specific and specify a timeframe in which they will accomplish this. will record their progress with video and photo.  This is powerful.  Your loved o  ne, likely does not see themselves often enough.  A visual reference point will be powerful along with your encouraging words and actions. Celebrate the success.  Even the goals they reach along the way are worthy of success but the final goal deserves celebration that is shared with other people.  Once your loved one has achieved their goal, they are one step closer to a more active lifestyle with greater wellness and this means that you, the caregiver, will have more opportunity for wellness.  Engaging in activity is crucial to living out a life of wellness and balance and I know that you will find success by following these steps.  Let me know what you need to know more about to make your caregiving journey less stressful https://www.caregiverbydesign.com/Free delivery from instacart  on your first order with this link:https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources:https://www.caregiverbydesign.com/FREE  exercises to help get the body movinghttps://www.caregiverbydesign.com/seatedexercisesaccess visual training and leave a comment https://www.facebook.com/caregiverbydesignSupport the show (https://angierischpater.mykajabi.com)

Even a body that can't move much at all can develop the ability to move better.  Why is this important?  Well, it can make your life as a caregiver a little bit easier and your loved one more productive and independent.  Imagine improving whatever movement that they already have just by doing 2 things: 1.   increasing the duration 2.  increasing the frequency. Quality of life improves while participating in functional every day activities.  They gain  independence and you gain a few minutes here and there for yourself.Ways to Achieve better movementFirst, realist that it doesn't have to be about more movement although that is good, let's start with BETTER movement because everyone can improve quality of movement.  Yes, everyone. Here are some of the things my therapist/clinical eye is looking for: Breathing qualityDissociation of movement of Upper body and lower body and left and right sides Tendency of posture, position in bed or while sitting on the couch, chair or at the table  Standing quality  (duration, balance, surface needs, confidence, awareness) The need for a  walking device that is best for more quality of movement.  Sometimes hand held is best Second: increase duration and frequency of movement as this leads to more strength and endurance.Examples to consider:  Increase the amount of time they are currently sitting at the table  from once a day to 2x by including their morning coffee / beverage.Increase the amount of time they are standing and walking by adding even one more activity to the daily routine.Begin a home exercise program ( option from me):  https://www.caregiverbydesign.com/seatedexercises that consists of basic stretching and strengthening and set a goal that they will see a mastery of by Christmas     (ex: start with 10 reps and get to 20 reps with ease,  Bigger goal - their exercise program will carry over into them being able to do a task that they couldn't before )  Did you know that grip is a great indicator of overall body strength and it can be increased with whole body exercises? Why is this important?  Grip is needed for success in so many tasks like: feeding yourself, putting on clothing, managing doorknobs and buttons and levers.  Your hands are a gait way to freedom in your day right.  Think about how this would impact your role as a caregiver too.  Where will you gain more freedom and opportunity to make time for your own activities. Don't forget about your needs, your vision and your goals.  You will find that gaining just a few moments a day will add up to an eventual valuable amount of time that will allow you to accomplish personal goals of relaxation and wellness that you deserve. Free delivery from instacart  on your first order with this link: https://instacart.oloiyb.net/c/2600855/415061/7412Get to know me and find more resources: https://www.caregiverbydesign.com/FREE  exercises to help get the body movinghttps://www.caregiverbydesign.com/seatedexerciseshttps://www.facebook.com/caregiverbydesignSupport the show (https://angierischpater.mykajabi.com)

I know you have thought this at one point or another.  It's so common and I know it can be frustrated.  When the one you care for is not motivated to move, exercise, get their daily self care done or get out of the house; you are often stuck too.  You want what is best for them and you really want to see them living life the best way they can but can't seem to say or do the right thing to get them moving.  "What do I do to get them motivated?", you ask.  My answer might surprise you.  You can not.  There is nothing you can do to motivate someone else.  What you can do is inspire them.  You can help them reconnect with purpose.  Chronic illness and the aging process guides one toward less activity or less of a  daily routine that has any sense of urgency.  Slowly, purpose is shifting and sometimes gets lost all together.   Once purpose is gone, it is very common to see a complete lack of desire to get moving, exercise, leave the home, do more for oneself; you get the idea.  Think about a time you have been ill, lost a job, been overwhelmed with financial strain.   You slow down and it's hard to find the momentum to get moving again.   But, then your circumstances change and you are able to find it again.   The one you care for usually does not have that opportunity.   The truth is, the more they are cared for by others, the less purpose they feel they have.  You can change that.  So, now what?  Well, there is always something that they do better than anything else.  Something they look forward to.  In this episode, I help you uncover what it might be.  This is where you start.  You are going to help them to improve the quality of how they perform this activity.  As the caregiver, you are going to help them to optimize their experience and in this effort, they will be moving with better quality, effort, energy and with an improved mindset.   Every little bit of change that you make in this direction will have a cumulative effect and you will see them develop the motivation you were hoping for.   Get your video tutorial of seated exercises that just about anyone can do.  Look for the changes in facial expression, voice quality, any degree of motion gained, respiration, posture.  Comment on these and encourage them further.  https://www.caregiverbydesign.com/Support the show (https://angierischpater.mykajabi.com)

Showering, bathing, toileting... it's all a bit overwhelming.  Those are just some of the big picture portions to your caregiving role and just thinking about them might be getting your stress levels going.  We are diving into some of the more specific issues related to hygiene; the ones that can really be a challenge.  Hygiene challenges. I spent years working in home care and in long term care settings and here are 4 areas that I found were either totally neglected or addressed infrequently and with poor thoroughness:Oral hygiene/ Teeth:  whether they can brush their own teeth or need help, this is an area that can be made easier with the use of an electric toothbrush, water pic or dental swap.  Dentures should be cleaned daily and the gums and inner cheeks should be cleansed at least daily with attention to all areas.   Infections can arise from poor oral care.  https://www.usa.philips.com/c-p/HX6850_60/sonicare-protectiveclean-5100-sonic-electric-toothbrush       Hair:  brushing hair daily will minimize hypersensitivity that can occur.  At least once a week shampoo treatment.  Using an  Apple Cider Vinegar rinse once a week can help balance out the scalps PH level.  https://www.healthline.com/health/apple-cider-vinegar-dandruff#how-to-use   Using an adaptive tool can help those with limited ROM in the shoulders, to reach their head  https://www.amazon.com/Body-Care-Long-Handle-Washer/dp/B00EQDEZX0/ref=sr_1_1?dchild=1&keywords=arthritis+hair+wash&qid=1605490958&sr=8-1  Feet:    it is very difficult for many people to reach their own feet and toes and it is an area that is difficult for caregivers to attend to carefully.  Quick tip on gentle self washing between the toes?  Use a bottle/cup washer that can get between the toes gently.   this adds at least 12 inches to the reach from the hand.  Changing socks daily is important.  I've known many individuals who keep them on for a week because they are difficult to change.  A dressing stick and a sock aid can help with this.  What's a dressing stick.  https://www.walmart.com/ip/RMS-Deluxe-28-Inches-Long-Dressing-Stick-Dressing-Aid-for-Shoes-Socks-Shirts-and-Pants/194520335 peri area:  https://en.wikipedia.org/wiki/Perineum women and men to keep these areas washed daily.  Use wet wipes instead of toilet paper.  Consider https://www.brondell.com/bidets/bidet-toilet-seats/ The risk for yeast infection goes beyond the genital area.  Yeast can grow in the creases of the inner groin, abdominal folds, buttocks creases.  These areas should be washed and dried daily.  The use of a hair dryer can be very helpful to dry hard to reach.   Coming up with a weekly routine for care, addressing these more challenging areas with a plan that gives you confidence and allows your loved one optimized independence will make a big difference. Support the show (https://angierischpater.mykajabi.com)

How much are you helping your loved one get out of bed? Unless your loved one is completely independent in getting out of bed, you know the struggle that getting out of or into bed can be.  It doesn't have to be so hard on your body.  Let's talk about how important good bed mobility for your loved one is and how to make this less stressful for you both.  Some things to consider are environmental aids such as: bed rails ( not the same kind you might be thinking)transfer pole ( floor to ceiling style that can be moved from one place to another if needed)wedgeshospital bedchanging the height of the bedmattress depth optionsApproaches to getting out of bed can make all the difference.   It is very helpful to recognize your loved one's challenges in bed mobility (pain, weakness, stiffness, fear).  Then, consider how to intervene to increase their potential by increasing the strength and the movement. Chances are, you are doing too much to help your loved one get out of bed, and with some critical thinking, analysis of movement, maybe the addition of some devices as mentioned above, you can increase their level of independence and lighten your burden at the same time.    Did you know that bed mobility strength transitions to other functional movements like getting off the couch, chair, toilet, car, tub?  Why not start and end each day utilizing getting out of bed to positively impact your loved ones' mobility independence for the rest of the day?  It could make a huge difference for both of you over time.   I hope you found this helpful.  https://www.caregiverbydesign.com  - free worksheet to take some stress out of your daily routineSupport the show (https://angierischpater.mykajabi.com)

Is the smell of dried, stale urine driving you crazy?  Do you feel like the situation is getting worse?  Maybe you feel like your loved one is hiding the severity of it from you and you are looking for a way to confront the situation.   Did you know that 1 out of 2 women over the age of 65 experience incontinence?  How about the 4 kinds of incontinenceurge incontinencestress incontinenceoverflow incontinencefunctional incontinencemixed incontinencehttps://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808#:~:text=Urinary%20incontinence%20%E2%80%94%20the%20loss%20of,to%20a%20toilet%20in%20time.There is something that you can do to minimize the impact that incontinence has on your quality of life.  I assure you that no matter what stage of incontinence your loved one is experiencing, a greater level of control can be experienced.  Finding a pelvic floor therapist that can help you with developing a unique intervention program for your loved is recommended.  Ask your primary care physician or urologist.   Ruling out other factors such as UTI, diabetes, kidney function, neurological dysfunction and other factors should be considered.  Factors such as diet and activity level have an impact on incontinence that are often overlooked.  Your loved ones hydration is a major factor and many people with incontinence avoid proper hydration for fear of additional leakage but concentrated urine can increase symptoms of incontinence.  Considering lifestyle changes that include mobility, timed voiding, diet changes, hydration, positioning, use of items such as a bedside commode if needed, and an exercise program to improve pelvic floor musculature are all ways that can minimize the negative impact that incontinence may have on your loved one's life.  More on the pelvic floor with preliminary exercises to increase awareness of the pelvic floor.  Watch and learn how to talk through some exercises with your loved one.   Try them yourself;  you will feel a difference.  https://www.youtube.com/watch?v=Ugj1w6qziUo&t=4sSupport the show (https://angierischpater.mykajabi.com)

Medications can be challenging on many levels for both the caregiver and the loved one.  As the caregiver, you may find this to be one of the most stressful moments of your routine.  You may have difficulty with your loved one taking the medications routinely on their own or with support.  Maybe your loved one is still living mostly on their own but they aren't consistently taking their medications.  This can be a very huge factor in remaining home without additional support. Tips on administering medications:You need to have an understanding of the medications that your loved one is taking.Knowing what side effects it may be causing in your loved onePairing the medications with a routine task.Motivate don't threaten Make swallowing the pills easier and the process quick and empowering if possibletake into consideration the triggers your loved one may haveFor individuals who live alone and need reminders or a person their to ensure they are taking there pills; look at the options on the market.  (top 8 pill dispensers) https://www.greatseniorliving.com/articles/best-pill-dispenser-for-seniorshttps://www.medacube.com/More about me: https://angierischpater.mykajabi.com/FB group for listeners of this podcast:https://www.facebook.com/groups/658781718322974Support the show (https://angierischpater.mykajabi.com)

Over the years I have found that there are a few simple but powerful things that hold my patients back from optimal function.  These may sound simple but they make a big difference.  Each of these affect a persons ability to complete their daily tasks, personal care, functional mobility and general wellness.crossing your ankle over your opposite knee: this simple motion makes it possible to get your clothing over your feet ( pants, socks , shoes) and it makes it easier to wash your feet and  so much more.   The mobility of the hip and knee in combination for this position is often lacking due to tightness, pain or anatomy.  It can be improved and every little percentage of improvement makes a differencegetting up from a chair the right way:  pushing from the surface that you sit, using your hands at your sides instead of pulling up from something in front of you.  Using the right muscles in your legs and shifting your weight over your feet correctly will allow for rising from a seated surface with less risk of falling. keep your ankles and toes moving:  mobile ankles and toes improve balance.  A stiff ankle will limit response time, increase trip hazard, shorten stride.  Toe mobility is needed for balance in standing, reaching, walking and also for proper hygiene.  take your wiggling toes for granted. sleeping in bed: once people start sleeping in a recliner or other chair ( yes, this is more common than you would think) they lose important mobility that carries over into other areas of their daily mobility.  It is also important for fluid reabsorption, true rest, spine and postural alignment and maintaining the use of key postural muscles that are used to get into and out of bed.  Hydration:  water intake is enormously powerful and can not be overlooked.  the lack of proper hydration leads to weakness, Urinary track infections,  low blood pressure, feeling of faintness, fatigue and more.   Unless you are on a water intake restriction from your MD for health reasons, the intake of this simple source is most likely a missing link to improved health and function. These 5 areas are what I investigate first as an Occupational Therapist completing an assessment and they are the last things that I remind my patients to keep doing when they are no longer under the care and training of myself and other clinicians.  Your invited to comment and share with others on this FB group.  Let me know what you need to know more about and where you need support.   https://www.facebook.com/groups/658781718322974Learn more about me and what I have to offer https://angierischpater.mykajabi.com/Support the show (https://angierischpater.mykajabi.com)

Caregivers often experience emotions that they don't want to admit to.  Your role as a caregiver is unique to you and your loved one and you will experience your own versions of emotion.  In this episode, I discuss the emotion that I observe the most in my role as an OT working with caregivers and their loved ones and it is resentment.Ways to recognize your emotion are discussed.  What to do when you encounter your main emotion.  Ways to minimize the power of the emotion over you and your loved one: Minimizing the challenges of everyday activities recognize what part of the day that is contributing to this emotionrecognize your emotion, own it, down let it own your dayCreate a path to move through the emotionPick one thing ( start with just 1) in your day that you can alter with your loved one, to allow for less contribution to this emotionMake more time for yourselftalk to your loved one about your feeling and your goalavoid a task and/or strain of a task creating a wedge between you and your loved oneMake your needs known to your support team ( therapists, MDs, family, friends).  I have been guilty of minimizing the role of the caregiver and the strain that they experience as an OT until I started asking the right questions to figure out what aspects of daily life could be going better and what I could do to help.  Caregivers, speak up, and let us know what is hard for you to do or what scares you.  Ask for help.  It is okay for you to feel whatever feeling you are experiencing and you are not alone.  I would really appreciate you leaving me a comment, sharing your needs with me so I can make an effort to address them in future episodes: https://www.facebook.com/groups/658781718322974Support the show (https://angierischpater.mykajabi.com)

As the caregiver, your role can be all-consuming and you might lose sight of how you want life to be.  Maybe you have given up on trying to imagine your life any different than it is right now.  It is a challenge to help manage your loved one's life and continue to live your own.  In this episode, you will gain some simple strategies to help you focus on your goals, create a vision for personal goals, and minimize the overwhelm that you may be feeling as the caregiver.   This will add value and quality to not only your life but your loved ones also. I challenge you to think of your role as a caregiver as a business whether you are a paid caregiver or not.  Let's face it, your most likely not doing this as a hobby.   If you think of your loved one as your business partner and you can set goals and create a vision with your loved one, you will feel a change and see a difference.  Invest in your business and watch it grow and flourish.  Sounds way out there?   It doesn't have to be such a stretch and when you change your mindset, you will find that it makes sense.  Support the show (https://angierischpater.mykajabi.com)

Episode notes:   This episode is a switch in audience focus.  As an occupational therapist of 22 years, I know where my passion lies and that is with building a connection between caregiver and loved one, building bridges from difficult to easy and from a life of dependency to greater independence.  I have been a caregiver to my husband in the past and I know first hand the challenges that arise and the emotions that are not easily discussed.     This is the first episode that will focus on providing support, education, and weekly updates to make the experience of helping your loved one remain in the least restrictive living environment and age in place, less overwhelming.  Find me on FB and Instagram -  Angela RischpaterSupport the show (https://angierischpater.mykajabi.com)

Lymphedema can be quite difficult to manage and often neglected by the patient because of limited access to therapeutic interventions.  In home care, an OT may find it difficult to get the patient started in an exercise program that is effective but it really can be simple.  In this episode, I give examples of 2 active cases I am working with right now and how a simple to follow set of exercises has made a significant difference and taken one patient from a non-ambulatory status to walking into her bathroom (20 feet) with confidence, in just 2 weeks.  Simple home program for the patient to manage their lymphedema includes:diaphragm breathingisometricsmanual drainagestanding/walkingdiet hygieneGetting your patient ready to attend outpatient Lymphedema treatment by a certified lymphedema therapist for further evaluation and interventions should be a goal to consider.  You can offer intervention strategies with some basic understanding of lymphedema and confidently get them started towards improved lymphedema management.   RESOURCES TO CONSIDERhttp://www.lymphedemablog.com/2018/03/16/diet-and-lymphedema/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+lymphedemablog+%28Lymphedema%3A+Inform+Yourself+and+Take+Control%29https://www.lymphcareusa.com/patient/lymph-a-what/ask-elvy/what-is-a-certified-lymphedema-therapist-clt.htmlhttps://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/How_to_Do_Self_Lymphatic_Massage_Lower_Body.pdfREFER TO PRIOR EPISODEShttps://www.buzzsprout.com/807851/stats/episodes/2538970-the-first-ot-session-at-homeSupport the show (https://angierischpater.mykajabi.com)

After many experiences with patients that struggle to move, have difficulty with pain and difficulty with blood pressure; the power of isometrics has become clear. Isometric exercises are far more effective than we think and they are often overlooked as we jump right into ROM and PRE with bands and putty.  When used with the right population and the right approach, isometrics can bring your patients increased ROM, decrease pain, and also make them feel empowered as they feel that there is an exercise they can do on their own. Some added benefits are that they don't usually require any equipment, can be remembered without pictures or written instructions or a second person and they can be done anywhere.  In this episode I discuss how it can be effective for:orthostatic hypotensionhypertensionrheumatoid arthritisfrail patientslymphedemaCheck out these links for more information on isometrics for Blood pressure: https://www.nature.com/articles/jhh201013https://onlinelibrary.wiley.com/doi/full/10.1111/jch.1352Support the show (https://angierischpater.mykajabi.com)

Are you thinking that you are stuck in pediatrics because it is all you know?  Do you think that the transition to working with adults is too far of a stretch for you?  This episode reviews 5 reasons that pediatric therapists are exceptional with the adult rehab population.  You may find that you are exactly what your adult patient has been waiting for.  Developmental progression focus:  your eye and clinical mind are in tune with the foundations that you need for advancing your patient to meet the goals.  A holistic perspective of the patient and their quality of movement is something that is often missed but makes an amazing difference. Creativity:  thinking quickly with creatively to be able to change your initial plans for treatment to suit the environmental and clinical needs of the patient,Patient driven sessions:  a pediatric therapist is accustomed to flowing with activity directed by the child's interest and energy levels.  This is a refreshing approach for adults who are often treated with the same activity session after session.Progression of activity:  A pediatric therapist has had the ability to work with their patient longer which gives them a better long-range perspective that makes goal setting and achievement for the adult much more holistic.  Comfort in using your hands:  pediatric handling skills are a welcome change to the adult patient who will feel more comfortable with a therapist who is comfortable with therapeutic touch and handling for facilitated movement and feedback.  Training to make the leap into adult rehab:  CHF, COPD, Diabetes, orthopedic rehab of the UE, vitals, and pharmaceuticals.  Getting some insight from experts will increase your comfort level when you get into the field on your own and help you know what to look for and how to intervene optimally. Need a fresh perspective as a long time adult rehab professional?  check out some pediatric courses and get a whole new perspective that will change how you approach your patient. Support the show (https://angierischpater.mykajabi.com)

Do you feel like you don't know enough about the pelvic floor and that means you don't have a role in training your patients appropriately?  Let this episode reassure you that knowing just enough to get your patient started can make a world of difference.  You can coach them through basic motions and muscle activation to increase awareness, increase relaxation and control.  I gained some basic knowledge from an online video course and putting it to use proved effective in my treatment sessions, giving my patients a feeling of success.  types of incontinenceurinary retentionminimize fall risk by improving continencesimple clinical assessments you can dosimple exercises with and without equipmentthe online course that improved my effectiveness: https://summit-education.com/course/PELVCL.1/functional-pelvic-floor-training-for-weakness-pain-and-dysfunction-in-men-women-and-older-adults#/onlinevideo/6-ceussee this episode on YouTube: https://www.youtube.com/channel/UCkf3lSUFi2ER0_i33go5k2g?view_as=subscriberSupport the show (https://angierischpater.mykajabi.com)

Covid 19 has drastically changed what seems like everything in just one week.  In my first week of treating patients in their homes during the Covid 19 crisis that gripped the nation; I found many things had to change in regard to providing therapy but first and foremost was my mindset.  Patient safety remains the first priority.  What has been most important during this first week of battling the Covid 19 crisis has been:maintaining patient trust demonstrating consistent precaution use focus on the benefits of OT for every patient and validate the medical necessitypanic vs gratitude mindsetMany therapists around the globe have lost their jobs in this crisis.  Now what?  This could be the opportunity to make a life change that you have been waiting for.  Use every challenge like this current crisis as an opportunity to strengthen who you are and what you have to offer.Support the show (https://angierischpater.mykajabi.com)

Knowing where your patient is safest and what to do when their home is not it.There will be times that this is going to mean that you make a call to your local adult protective services department.  Knowing when that is the right call to make and how to proceed can be a challenge but in this episode, I share my experiences with it and go through the steps of assessing when it is time to call.  The OT has a role of maximizing a patient's independence and quality of life in any setting.  Working with the patient's care managers, social workers and interdisciplinary healthcare providers on the homecare team will direct you in helping your patient find the best option for independence and safety. https://www.napsa-now.org/   adult protective serviceshttps://www.verywellhealth.com/geriatric-care-manager-job-description-197837 care manager informationSupport the show (https://angierischpater.mykajabi.com)

As a home care OT, you are the patient's closest access to immediate medical attention when you are making your visit.  With increase in the frailty and vulnerability levels of the patients being discharged from the hospital to their homes, the burden falls on the healthcare providers serving them at home to identify when the need for more advanced help is required.  Knowing the normal parameters for vitals along with the signs of distress will make you a valuable source of information when you contact the primary care provider who will then direct the patient's next steps.  Learn more about lung sounds and heart sounds to help you know what might be going onhttps://www.easyauscultation.com/lung-soundsHospital readmission rates https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3802532/Support the show (https://angierischpater.mykajabi.com)