Caregiver Connections
Helpful tips for family caregivers

Home modifications for vision loss

If the person you care for has a low vision diagnosis, three types of modifications to the home can make life easier: Lighting, glare control, and the use of color contrast. Fortunately, these strategies are relatively inexpensive.

Lighting. Sunlight is the best. It’s full-spectrum light. But it fluctuates depending on the time of day and the weather. Fluorescent bulbs are advised for general room lighting, although they cannot be dimmed. Incandescent lights can be dimmed, but they tend to produce visual “hot spots” or glare. Their best application is in a gooseneck lamp for close-up tasks. Lights recessed into the ceiling are optimal for spotlighting dark areas without creating glare (for example, a closet, hallway, stairs). Track lighting is lower cost, but it sometimes creates glare.

Glare control. Glare arises when reflected light creates too bright a hot spot relative to the rest of the room making it difficult for the eyes to adjust. Strive to reduce shiny surfaces. Also, to control surrounding light.

• Choose mini blinds or vertical blinds for maximum control of glare from the sun.
• Install dimmer switches to even out lighting brightness.
• Avoid using glossy paints or polishing furniture or floors to a shiny finish.
• Have tablecloths or other throw-ons available to cover bright surfaces as needed.

Color contrast. Light colors used in contrast to dark or bright colors instantly make it easier for your loved one to locate important items or get oriented in a room. For instance:

• When walls are white, paint doors, doorjambs, and baseboards with bright colors to highlight the boundaries of a room. Use a dark switch plate around light switches and outlets.
• Choose solid floor coverings (carpet, wood, tile) instead of those with patterns.
• Provide a dark desktop for tasks involving paper or a white plate for dining on a dark table top (or cloth).
• Place a dark armchair against a white wall and/or a light-colored floor or rug.
• Place brightly colored tape on the edges of cupboards and drawers to help your relative know when these are open, safeguarding against bumps, cuts, and falls.
• Red, orange and yellow—solid, bright colors—are more visible than pastels and/or dark colors.

Is it time for memory care?

If you care for a loved one with moderate to advanced dementia, it’s likely the idea of placement in memory care has come up. Maybe a friend has nudged you. Or it’s been suggested by your relative’s doctor or care manager. Perhaps you know you are exhausted. Most families eventually investigate this option because it’s staffed 24/7 by people trained in dementia strategies.

The most common reasons families make the shift

• The person is in danger of harming themselves or others (for instance, wandering, or aggressive outbursts).
• The family caregiver’s mental or physical health is going downhill.
• The person is incontinent.

Your feelings may cloud wise judgment. People with dementia don’t recognize their need for help. It is up to you to make a wise decision for them. But strong feelings may hold you back:

• Guilt or betrayal. You promised you’d never send them to a nursing home. Sometimes we can’t keep every promise. Who knew dementia care could be so hard? Visit a few memory care communities. Given their focus on keeping residents happily engaged in activities, they are generally much sunnier than a nursing home.
• Shame or embarrassment. Others may judge you. None of them have walked in your shoes. Go to a support group of family caregivers and hear their feedback. Your decision addresses the need for safety and good health for everyone involved.
• Worry your relative will get worse. No one can care for them as attentively as you can. That’s true. And an uptick in confusion and disorientation is common at first. About six weeks in, however, you’ll likely see them more engaged as they join others in activities.

If you are struggling with this decision, consult with a care manager or social worker. They can even facilitate a family meeting to get everyone on the same page.

If you are not the primary caregiver

If someone else in your family has primary responsibility for the care of your loved one, that doesn’t mean you don’t have anything to contribute. Far from it! Caring for an older adult is more than one person can do alone. There are many ways to lend a hand (even if you don’t live nearby).

Consider:

• Managing finances, talking with the doctors, doing yardwork, running errands. If direct care isn’t your thing, address other needs. Anything you can take off the plate of the primary is a help.
• Contributing money. If you live far away and have the means, pay for outside help to give your sibling some relief.
• Providing emotional support. It’s often very lonely to be the primary caregiver. Having a good listener to talk to for safely blowing off steam can ease the load.
• Giving them a break. Gift them a “spa day” where you make all the arrangements and they just enjoy. Spend some of your vacation time caring for mom or dad so the primary can have an extended rest.

“My sister would never go for that!” The biggest complaint in many families is that the primary caregiver is so particular, it’s impossible to help. True. They may have trouble letting go of control. As long as there is nothing medically dangerous about what you propose, however, you may need to assert yourself and express your right to participate in your parent’s care in your own style.

If you get resistance, consider a facilitated family meeting. Family dynamics are decades old. A counselor, social worker, or care manager can guide a conversation constructively. Families are an ecosystem and each member inhabits a niche. It will be better for your loved one, and for you and your siblings, if everyone has a chance to contribute, each in their own way.