August/September 2023 - Guardian Angel Hospice

How is your relative's "social health"?

The U.S. Surgeon General reports we have a loneliness epidemic.

Like smoking and obesity, social isolation creates a greater risk for poor health. It’s been associated with a 48 percent increase in “premature death” (a death where a change in lifestyle could have resulted in a longer life).

Our social health affects our physical health.

Isolation. How much contact is enough? Canada is working on “social health guidelines” that would serve much like the nutrition guidelines put out by the Food and Drug Administration in the United States. They recommend one to three hours of socializing per day. Even light exchanges with a salesperson or sharing a laugh at the dog park count. We are social beings! That said, it’s family and old friends that make us feel seen, understood, and loved.

What you can do. The motivation and action must come from your loved one. But there are things you can do to remove or reduce barriers.

Transportation. What are the barriers to attending an event? Are there ways you can help? (Provide a ride. Facilitate a Lyft or Uber account.)
Hearing loss. Hearing loss can make conversation a chore. Hearing aids will help. Consider also a phone for the hearing impaired that can boost volume as needed.
Home environment. Is your loved one too embarrassed by untidiness to invite people in? Consider housecleaning help or setting up visits outdoors on a porch or patio.

Tips for socializing. We got out of the habit with the pandemic. Here are a few insights:

It’s easier to revitalize an old friendship than start a new one. It takes time and repeated exposure to cultivate a new friend.
Create a two-person book club. Suggest reading and discussing a book with a friend or acquaintance. Or pick a TV show or streaming series to watch and discuss. The repeated exposure builds rapport.
Small gestures are powerful. We’re naturally drawn to people who seem to like, notice, or appreciate us. A “thinking of you” text or a congratulatory email can go a long way toward building or strengthening a friendship.
To gain a friend, be a friend. Suggest they look for opportunities such as offering to pick up the newspaper when a neighbor is gone or becoming a morning check-in buddy for someone else who lives alone.

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Low-vision bathroom

The bathroom is often the most challenging (and least safe) room in the house for someone who is visually impaired: Poor lighting, or lighting that’s too bright. Lots of white-on-white furnishings and shiny fixtures. Hard-to-read settings on faucets. Tiny caps and tamperproof closures on personal care products and medications. And many small items for specialized tasks. Consider the adaptations below as you strive to make your loved one’s home environment support their independence.

Color contrast. Linens such as towels and washcloths should be a strong color contrast with wall, tub, and counter surfaces. Install a nonskid, high-contrast bath mat so your relative knows where to stand and not slip. Wrap grab bars with colored tape so they stand out from other shiny surfaces. Teach your loved one to float a brightly colored sponge when filling the tub to more easily ascertain water height. A contrasting color for the toilet seat is also helpful.

Lighting. Experiment with different types of light in different situations. For instance, there are toilet lights that give off a soft glow inside the bowl for nighttime navigating. For detailed work, like shaving or putting on makeup, add a magnifying mirror on a flexible arm. Some include lighting.

Faucets. Set the hot water heater to medium-range temperature. Mark sink and shower faucets with a bright color or contrasting texture to show the position for comfortable hot water. Have your relative use an on/off, handheld shower nozzle to test shower water temperature before stepping in. In two-faucet situations, learn to turn on the cold water first, then add hot water. Similarly, turn off hot water first and then the cold.

Clutter. Purchase a shower caddy to keep shampoos, razors, and soaps all in one place. Place a rubber band around the shampoo bottle to distinguish it from the conditioner. Provide soap on a rope so the soap is less likely to slip away.

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Adjusting to memory care

Once your loved one is in their new home, the two of you will have a lot of adjusting to do. Like any big change, it takes time to find a new internal balance, a “new normal.” One to three months is about average.

For you. Expect a range of emotions: Sadness, guilt, doubt, and anxiety. You may feel that you’ve failed. Understand that 90 percent of families are not able to provide the necessary 24/7 care. It’s the disease that’s to blame, not you. Acknowledge that their new environment provides fresh shifts of care providers around the clock. It also gives your relative access to activities and opportunities to socialize. There are good reasons you made this choice.

For your loved one. They too will have feelings arise and be confused. It may seem that their dementia is suddenly worse. (This is a natural response to disruptions in routine. Over time the initial anxiety and agitation will diminish, although the disease will also be progressing, as it would have at home.) Listen to their feelings and acknowledge them. “I know this is hard. I don’t like it either. It’s not something we expected!” Trying to talk them out of their feelings usually backfires. And reasoning is not their strong suit. Instead, have a story in place that the family and staff all repeat: “The doctor said you need to stay here for a while.” “The house isn’t safe right now.” Don’t say that this is their new permanent home. Just let them know they are safe and that you know where they are.

Other tips

Follow staff guidance about frequency and length of visits.
Ask the staff if your relative’s behavior is normal for the length of time they have been there.
Participate in activities when you visit so when the activity concludes, it’s natural for the visit to end too.

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How is your relative's "social health"?

Low-vision bathroom

Adjusting to memory care