The challenges of care giving for an aging or ill loved one are limitless. Often, family care givers are taxed with not only demanding physical care — but also tending to emotional issues, and a shift in family paradigm. If you are a family care giver, you’re not alone. Twenty-Nine percent of the U.S. population are acting as care givers for family members, and sixty-six percent of those are women caring for their aging parents, cites the National Family Caregivers Association. The challenges of care-giving are much more severe when an adult daughter must care for her elderly father, due to physical differences in size, privacy considerations and changes in established familial roles.
Overcoming Physical Challenges
For a woman whose father is much taller and/or heavier than she, risk of injury to both the family care giver and her loved one is ever-present. Crystal Ranker, Occupational Therapist, and her team at the Total Long-term Care Cody Center, recommends the following strategies and techniques to help you avoid injury while participating in daily tasks:
Transferring into and out of bed: Ranker and her team recommend trading your father’s standard bed for a hospital bed, if possible. A home health nurse or provider can help you select the best bed for your loved one. Hospital beds allow the user to adjust the height, which decreases strain on the family care giver’s back. This vertical movement also allows the family care giver to adjust for optimal transfer position. If a hospital bed is not an option, alternatives include bed rails, a bed cane, a floor-to-ceiling pole, a gait belt, a sliding board, or a Hoyer lift — a tool that acts as a sitting hammock or sling, and allows for easy transfers with minimal physical effort.
Transferring into and out of the car: Ranker recommends installing a suction handhold or strap in your motor vehicle to ease transfer. When entering or exiting the car, it is best to use a technique called a “pivot transfer,” whereby your father’s backside is positioned down first, with his feet facing out of the car, then your father bring his legs in with help from you, one a at a time. You may even want to place a garbage bag underneath him to act as a sliding surface.
Transferring onto and off of the commode: The use of a raised toilet seat, a toilet safety frame, or an over-toilet commode can provide increased height for easy sit-stand and hand-holds, which will ease the transfer process for both you and your loved one. Grab bars placed by the toilet can also give your father the ability to balance himself, while keeping clothing and privacy intact. If your father is unable to get to the toilet, a bedside commode or a bed pan/urinal may be useful.
Transferring into and out of the shower: If your father prefers to bathe in a bathtub (or does not have a shower), use a transfer bath bench to make it easy for your father to sit and slide over the edge, and into the tub. If your father has a walk-in shower, you may want to use a standard bath bench (with or without a back) that has adjustable legs. Increasing the bench’s height makes for an easy sit-to-stand transfer. Encouraging independence while bathing with the use of bath benches may boost your father's confidence and maintain his dignity, even while you are assisting him. Also consider installing grab bars, both outside and inside of the shower or tub. If your father is unable to walk to the shower or bathtub, consider investing in a roll-in (wheeled) shower chair.
Transferring into and out of a wheelchair: The ease of this transfer depends on the extent of your father’s mobility. If your father is mainly sedentary, use a “sliding board” to go from one surface (bed, chair, car) to the wheelchair. If your father is ambulatory, try using a walker to back up to his wheelchair, then have him use the arm rests to help lower himself into the chair. A Hoyer lift, as mentioned above, may be helpful to transfer from any surface to a wheelchair, as well. Regardless of which method you choose, Ranker and her team recommended the use of a gait belt for all transfers to ensure optimal safety.
Overcoming Privacy Challenges
Daily tasks, such as using the commode, bathing and changing can be difficult, and bring privacy and dignity to the forefront. In these situations, it is important to be patient, reassure your father you are there for him, and respect boundaries as much as possible.
Bathing and showering: It’s important to let your father bathe as much as he can himself. If he needs assistance, use a shower or bath bench and wash one body part at a time, while keeping a towel to cover other body parts. Also consider helping your father bathe most of his body, leaving more private areas for him to finish with a handled sponge.
Using the restroom: Methods of maintaining privacy while using the restroom vary depending on the abilities of your father. If he’s able to stay seated safely, assist him to the bathroom and onto and off of the toilet, but step outside while he’s actually using the restroom. If he can’t use the restroom on his own safely, ensuring his well-being is much more important than privacy. You may help him onto the toilet and steady him, and look away until he finishes and needs assistance getting up.
Changing: There are a number of ways to keep privacy while helping your father get dressed. Begin by setting all of his clothes out on the bed, so they’re easy to access. Change one piece of clothing at a time to keep as much skin covered as possible, and look down while helping him pull on undergarments and pants.
Overcoming Emotional Challenges
Helping your father maintain independence and confidence in his aging years is essential, as the loss of self-sufficiency and reversal of family roles may be hard for him (and you, the family care giver) to handle. These struggles can be challenging to overcome, but certain tools may help alleviate some of the stresses.
Maintaining independence: It’s essential to let your father complete as many tasks as possible on his own. If he needs help getting dressed, allow him to pick out his clothes for the day. If he’s able to make himself a sandwich, by all means, let him! If he needs help getting into bed, involve him in the process by saying things like, “On the count of three, you are going to stand up and we are going to move towards the bed.” Ranker also suggests the use of adaptive equipment, such as a “reacher,” grip bars, and walking aids. Encourage your father to make decisions related to his daily activities and personal care, and make sure he stays involved with family and the community.
The reversal of family roles: Role reversals between the adult daughter and her father can cause confusion and stress for all involved. Your father, who was once the caretaker, is now in need of care from his daughter — which often leads to frustration, depression, and feeling like a burden, says Ranker. The adult daughter and caretaker (you) have probably always been cared for by your father, and now his well-being is your responsibility — which can be frightening, demanding and hectic. As your father struggles to accept the outcomes of his aging, you have to witness the many changes. For both parties, looking to community support for help, and maintaining open lines of communication can make the transition easier.