Because We Care
Practical tips for family caregivers

Could an adult day program be the answer?

Perhaps you’ve heard of “adult day care.” Although you may be reluctant to consider it for your parent, research shows the benefits are undeniable.

Three basic kinds of adult day programs are offered across the country.

• Adult social programs provide activities, meals, and personal care.
• Dementia-focused programs are like social programs but are geared for individuals with memory loss.
• Adult day health programs provide activities and meals, as well as therapeutic and social work services. They serve individuals with serious medical concerns and/or dementia.

Most programs provide transportation to and from the center. The average cost is $67/day, although you may be eligible for assistance. (If your loved one spends at least 8 hours a day living with you and is financially dependent, you may be eligible for Dependent Care Tax Credits from the IRS.

Day programs create a win:win for you and your parent. Researchers report:

• Reduced stress for family caregivers.
• Increased quality of life for program attendees.
• Fewer dementia-related behavior problems over time.

Concerned that your parent will say “no”? Studies of dementia-focused programs find this is not a common problem. Still, follow these tips for a successful transition:

• Start slowly. Have your loved one attend for a few hours at first, then a full day. Build up to several days a week.
• If your loved one has dementia, new places and faces may cause anxiety or resistance. Stay with them initially to ease their adjustment.
• If your loved one does not have dementia, be sure the program has other non-impaired attendees.
• Discuss your concerns with center staff. They are experienced at helping newcomers fit in.

See our Community Programs page on adult day centers for more details

 

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How nutrition affects breathing

Food and oxygen are the basic fuels that we need for the cells of our body to do their jobs. People with COPD have to expend more energy breathing. Because their exhales are not always efficient, they tend to develop high levels of carbon dioxide. Not good.

Fortunately, there are food choices that can reduce the problem and provide maximum efficiency for breathing. Check these out:

Foods to limit

• “Gassy” foods. Beans, cauliflower, brussels sprouts, and broccoli are examples, and so are carbonated beverages. They cause the stomach to expand, which puts pressure on the diaphragm. Some people also get gas from apples, stone fruits (e.g., apricots, peaches), and melons.
• Sugars. Simple carbohydrates (sugars and starch) produce more carbon dioxide than do fats or proteins. They make more work for the lungs. Avoid candies, cookies, cake, and soft drinks.
• Salt. It can cause the body to retain fluid, making it harder to breathe.
• Dairy. Milk and cheese often produce thicker phlegm, making it difficult to keep the lungs clear.
• Fried foods. While healthy fats are good, the fats that are typically used in frying—saturated fats that are hard at room temperature, such as butter or lard—often cause bloating and indigestion. This puts pressure on the diaphragm, making it harder to breathe.

Foods to eat

People with COPD need more protein and calories to build up the muscle of the diaphragm and to provide fuel for the extra effort they have to expend to exhale effectively. Carbohydrates provide calories, but have the side effect of increased carbon dioxide. A focus on healthy fats and proteins is the best way to help your loved one keep carbon dioxide low and calories sufficient for the extra work of breathing.

• Healthy fats. Polyunsaturated fats provide calories without the carbon dioxide that carbohydrates tend to produce. Natural sources of these “healthy fats” include avocados, nuts and seeds, oily fish (e.g., salmon, mackerel, sardines), olives, and olive oil.
• Protein. Eggs, lean red meat, and oily fish are excellent sources of the proteins that provide the building blocks for the muscles needed to handle heavy respiration.
• Water. To make it easier to keep the lungs clear, have your loved one drink between six and eight 8-ounce glasses of noncaffeinated beverages each day. Good hydration will help keep phlegm thin and easier to cough up. Best to drink water between meals.

When to eat

• Smaller, more-frequent meals are optimal. Try for five or six per day. It’s harder to breathe when your stomach is full. Similarly, reduce fluid intake at mealtime to keep the stomach from getting distended.
• Eat the big meal in the morning. This will provide an energy boost ahead of the day’s activities rather than closer to bedtime.

As always, check with a doctor or dietitian to determine the diet that is right for your loved one.

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Travel tips when your loved one is disabled

It’s difficult to know what to anticipate when traveling with a frail family member. Here are tips from experienced, disabled travelers to reduce your road-trip stress this summer.

If your travel includes hotel lodging:

• Talk directly with the hotel. Many chains have a centralized reservation system. Get a direct, on-site number instead. Then ask to speak with the head of housekeeping or engineering. With their intimate knowledge of the building, you can ask them to describe the disability features: How wide are the doorways? Does the bathroom have grab bars? And don’t forget to ask about access to the hotel from the street!
• Reserve the room. Confirm that you are guaranteed an “accessible” room. Reconfirm a few days in advance of your arrival. If your room is not available or not accessible, ask to speak with the manager. It is the hotel’s responsibility to find you suitable alternate lodgings.

You might also consider bringing these items. You’ll find them sold online or at medical supply stores.

• A folding ramp. An easy way to eliminate a short flight of stairs.
• Safety items for the bathroom. Consider a lightweight toilet seat extender. For bathing, look for a suction-based grab bar, or folding shower bench and slip-on shower hose. Add nightlights to improve visibility after dark.
• Chair comfort. Bring a lap blanket and special pillows if your family member will be spending a lot of time sitting. Or a small fan to help with cooling. A swivel seat cushion may help a lot with getting in/out of the car.

To help your loved one join in excursions, consider a wheelchair. A wheelchair can preserve your family member’s energy. All transport chairs fold, but some are made for travel and pack easily in a small bag.

 

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