Essential Caregiver Tips for Making At-Home Care Easier

Caring for an aging parent can be an emotional rollercoaster—satisfying on some days, overwhelming on others. "It can be very rewarding and frustrating, and we need to normalize that both things can be true at the same time," says Marvell Adams Jr., the Baltimore-based CEO of Caregiver Action Network, the nation's leading non-profit organization dedicated to supporting more than 51 million Americans who serve as caregivers to someone over the age of 50.

While many people find joy and meaning in the ability to help their parent as they age, "many caregivers also tell us they feel isolated," says Adams. "They are expected to continue working, raising children, managing households, and maintaining relationships while taking on what can feel like a second full-time job." With such a full plate, strategies to lighten the load are important. The simple tools and techniques here can help.

Focus on Safety First

Safety is the number one priority when providing elder care at home. "Having the equipment you need and understanding the correct techniques for safe mobility and transfers can help prevent falls and keep both your parent and you as their caregiver safe during mobility tasks," says Melissa Werz, O.T.D., an occupational therapist and instructor in the occupational therapy doctorate program at Duke University School of Medicine in Durham, NC.

But don't just have equipment at the ready—use it before you think you need to, says Werz. "Don't wait for a fall!" she says. If you are noticing a decline in your parent's balance or stability when walking and are concerned about a fall risk, "consult with a doctor to share your concerns and consider a referral to an occupational therapist (OT) to learn strategies for home safety techniques and possible equipment recommendations." An OT will assess how your parent's mobility challenges impact activities throughout the day and suggest ways to reduce the risk of falls while maintaining their quality of life.

The Care Action Network recommends additional safety guidelines for senior caregivers:

• Remove potential hazards like loose rugs and electrical cords from walkways and ensure paths throughout the home are clear.
• Install secure handrails along both sides of staircases and in key areas like bathrooms.
• Ensure the entire home is properly lit and improve nighttime safety with lamps near beds and motion-activated nightlights in bedrooms, bathrooms, and hallways.
• Use non-slip mats in showers and bathtubs, along with shower chairs or grab bars if necessary.
• Place frequently used items within easy reach to avoid the need for step stools.
• Inspect flooring throughout the home and replace any highly polished surfaces with non-slip alternatives.

Learn Safe Transfer Techniques

When you're helping your loved one move from the bed to a chair, or helping them stand from a seated position, there is a real risk of throwing out your own back in the process. The right body mechanics can help caregivers protect their spine and joints:

• When leaning forward to lift your parent, always position your feet shoulder-width apart for a stable supporting base.
• Instead of rounding your spine, keep your back straight, which helps to properly engage your core muscles and prevent injury.
• When lifting or assisting your parent to stand, bend from your knees rather than your waist.

A gait belt can help with safe transfers, says Adams. This device fits snugly around your parent's waist, over their clothing, and lets you lift or provide support by holding onto the belt (some have handles), rather than risking injury to yourself or your parent by lifting them via their shoulders or arms. Additional equipment to help with transfers includes transfer boards, lift chairs, and ramps.

The anticipation of moving from sitting to standing can be stressful for a parent who knows they struggle with it. You can help make the transfer process smoother by communicating with your parent throughout with simple, encouraging phrases. The Care Action Network recommends "let's take our time" and "ready to stand" as short commands to guide your parent through the process.

Make Bathing and Personal Care Easier

If your parent has limited mobility, they may rely on you to prepare the bath, assist in the washing process, and help them in and out of the shower or tub. You can make the bathing experience safer with caregiver tips from Adams:

• Install grab bars on the shower wall and in the tub itself.
• Remove all trip hazards from the bathroom floor, including area rugs and clothing.
• Make sure the room is warm before you start.
• Always test water temperature before your loved one gets wet.
• Use a transfer or shower chair to help your parent safely move into the stall or tub.

Bathing your parent is tricky: They require careful monitoring for safety reasons, but the process is also intimate, and you don't want to invade their personal space. To maintain your parent's privacy and dignity, you might suggest they wear clean undergarments that cover their private areas or a towel that can be lifted only when necessary. If they are able to grasp a washcloth, encourage them to clean themselves as they sit in the tub or shower chair. Gentle conversation or background music can provide welcome distractions.

Prevent Bedsores and Skin Problems

Pressure ulcers (commonly known as bedsores) can develop if someone spends too long sitting or lying in one position, making seniors with mobility challenges particularly at risk. Bedsores are also more likely if the person's skin is thin, dry, or weak due to aging or disease.

As a caregiver, look for early signs of a bedsore: a red patch anywhere on the skin (especially over raised, bony areas like the buttocks, spine, and heels) that stays red when you press it lightly with a finger. The area may also be painful, hard, or hot to the touch.

If you help your loved one wash or dress, this is a good opportunity to spend a few minutes checking their skin, especially around those bony areas. Contact your healthcare provider as soon as possible to seek advice if you think you've found a pressure ulcer: If left untreated, the open wound can lead to life-threatening bacterial infections, per the Cleveland Clinic.

If you do spot a bedsore, remember: It's a factor of your parent's sedentary lifestyle, not a flaw in your caregiving. Still, it's good to try and prevent bedsores from forming. To do that, keep the following in mind:

• Encourage your loved one to change positions every few hours, whether sitting or lying down.
• Support movement throughout the day, even if it requires assistance.
• Set a timer, alarm, or other memory aid once every hour during the day to remind your loved one to stand, roll to one side, or otherwise shift their body weight.
• Ask your healthcare provider or OT about pressure-relieving pads, overlays, or mattresses to reduce the risk of bedsores.

Encourage Daily Movement

If someone is losing mobility, they may report feelings of stiffness and possibly loss of balance. "The person will notice they are moving differently during routine tasks; this is compensation for stiffness," explains James Higgins, D.P.T., a doctor of physical therapy at Integrative Physical Therapy of NYC in New York City. Weakness, imbalance, and deconditioning make seniors more susceptible to falls, but regular physical activity, including strength training, helps combat this, says Higgins.

He recommends these simple exercises for seniors with limited mobility to do at home:

• Move from sitting to standing position in a chair (ideally hands free); sit back down. Repeat 10 times.
• From a seated position, practice heel raises by placing feet flat on the floor then lifting heels as high as you can while keeping toes on the floor. Lower heels. Repeat 10 times.
• Perform a wall push-up by facing a wall about an arm's length away, hands flat against the wall at shoulder height. Bend elbows and lean into the wall, keeping body in one long, straight line. Do 5–10 times.

If your loved one wants to exercise from a chair, try these additional exercises:

• March in place. While seated, slowly lift one knee toward the ceiling as high as is comfortable, pausing briefly, then lower foot back to the floor with control. Repeat on opposite side. Continue for 60 seconds.
• Knee extensions. While sitting, slowly straighten one leg in front of the body until knee is almost fully extended. (Don't lock the joint.) Do 10 times on each side.

For more structured help with your parent's fitness, seek out a physical therapist who works with seniors. They can offer strength and conditioning programs that meet your parent's fitness level. A qualified physical therapist will identify strength and mobility deficits which can lead to injury and falls, and rectify them.

The Right Products Make Caregiving Easier

Along with strategies for practical care, having the right products at your disposal to support your parent's daily activities can lessen the load on you. What those products are will depend on how much mobility your parent has, and what their daily routine looks like.

Mobility Aids That Improve Safety

Rollators, manual wheelchairs, and power (electric) wheelchairs each have pros and cons. What's right for your loved one depends on their individual situation. Werz recommends getting professional advice from an occupational or physical therapist on the right mobility device. "They'll make sure it meets your parent's needs—and also that it works in your home, as not all equipment fits through every doorway," she says.

Bearing in mind that it isn't one-size-fits-all, these are some of the main differences to keep in mind:

• Four-wheel rollators are stable and enable easy turning in tight places.
• Some rollators come with baskets or trays for transporting items between rooms, as well as seats to sit on if your parent needs to rest.
• Manual wheelchairs can be pushed by a caregiver or wheeled by the user but require upper body strength, potentially limiting the distance of travel.
• Power wheelchairs are ideal for people with limited upper body strength and come with adjustable armrests, headlights, horn, rear reflectors, and anti-tippers for safe, comfortable rides.
• Scooters require more space to operate but are also a roomy, comfortable way to travel.

Not all devices are covered by insurance, but you can often use your Flexible Spending Account (FSA) to help with your purchase.

Bathroom Safety Equipment

Various items help to keep your loved one safe when using the bathroom. "Bathroom equipment may include shower chairs, tub benches, grab bars, raised commode seats, or simply a chair to sit in when changing clothing," says Werz. "Other options may include things like long-handled sponges, and a handheld shower head to reduce bending over as much. Non-slip bathmats or slip-resistant shower tape for the floor of the shower can be helpful."

To mount grab bars in the shower, the Americans With Disabilities Act (ADA) guidelines recommend positioning them about 36 inches from the floor. This height makes it easy for someone climbing in or out to hold on without bending over.

Bedroom and Transfer Aids

Safety equipment in the bedroom ranges from having a sturdy chair for your parent to sit in when getting dressed to a lift chair that gently raises the seat on an incline to help someone with mobility challenges safely sit down and stand up.

"Typical bedroom safety equipment also includes a head rail to help with turning over in bed, slide sheets to make bed mobility easier, and an adjustable bed base to change the angle of the head and foot of the bed," adds Werz.

Small Changes Can Make a Big Difference

Any way you look at it, the responsibilities of caring for an aging parent are intense. Little changes in how you lift them out of bed or upgrade from a walker to a rollator to help them get around can make caregiving less stressful and more sustainable.

It's also wise to plan for the unexpected. For instance, Werz recommends having a safety plan in place if your elderly parent is spending time at home by themselves, including a fall detection device or a smart watch with fall detection which you can set to alert a family member. Most importantly, remember that you are not alone. "There are a lot of resources and professionals who have the skills to educate you and your family on safe senior care at home," she says. "It's never too soon to start."