This is a multi-part series to help caregivers learn how to assist older adults with their personal care. Activities of Daily Living, or ADLs, are basic self-care tasks. Here, we will focus on how and why we help by using ADLs. We’ll also discuss how to assist adults with eating and drinking.
Personal Care: Why is helping older adults with everyday activities so important?
Think about all of the little things you need to do each day. Just to start your day you must get out of bed, take care of your personal hygiene (bathe, shampoo hair and brush your teeth), pick out clothes, get dressed and eat. Many little steps are required to do each of these things. For example, getting out of bed requires that you are able to roll to the side of the bed, swing your legs over the edge of the bed, place your feet on the floor and stand. The important, personal care you provide helps to keep the older adult as independent as possible, safe, healthy and improve their quality of life.
Honor individual preferences and independence
We all have preferences about when and how we like to do things and it is important to honor others’ preferences whenever possible. The older adult you are caring for has had some loss in their ability to fully care for themselves. It is, therefore, important to help them feel that they still have some control in their daily lives.
Involve them in choosing when and how you will do certain activities and encourage them to do as much as they can on their own without being overly dependent on your help. Although it may take longer for an older adult to do a particular task, it is best for them to do as much as they can for him/herself. Be patient. When you are unsure if your help is needed, just ask.
Helping adults with drinking
An older adult needs about 8 glasses of water per day. Having enough water helps prevent urinary tract infection and constipation.
Dehydration occurs when a person does not get enough water. An older person may not feel thirsty, even when they needs fluids, because ability to detect thirst decreases with older age. Many older people also don’t want to drink too much because they are afraid they may have to go to the bathroom too frequently or have an accident.
Drinking water should be available to older adults at all times. If an older adult has an impairment that affects their ability to drink, you may need to offer a straw or small sips and assist them to drink throughout the day.
Avoid soda and juice as much as possible because they are high in sugar. Coffee, tea and soda also contain caffeine, which actually dehydrates, or draws water out of, the body even more. Alcohol also dehydrates.
Helping adults with eating
Mealtime is an important social time. Use a calm, friendly and encouraging tone when helping with mealtimes. This will go a long way toward making it special.
- Serve the meal by placing it within easy reach.
- Make sure the older adult has all the utensils they will need.
- Check frequently to see if they need help.
- Offer to cut food for an older adult who is having difficulty. When cutting food, always make sure the pieces are small enough to help prevent choking. An older adult with arthritis may also need help with things such as opening milk containers.
- Offer different food if an older adult refuses what was offered.
- Allow them time to complete one course before starting another.
- If needed, help the older adult check their personal appearance before moving away from the table. For example, check to see if there are any food spills or crumbs that need to be cleaned. Help an older adult to wipe his/her face, if necessary. Make sure they feel presentable.
You need to be aware of the possibility of choking on certain foods. Some helpful hints for alternative food choices or preparation methods might include:
- Cutting, grinding food, or turning it into a cream sauce - If you are family caregiver, make sure this is ok with the older adult’s healthcare provider, and if you are a professional caregiver, make sure this is on the care plan.
- Serving a rich soup or blended meats and vegetables to increase calories.
- Using mashed or pureed fruits and vegetables or their own juices to make dry foods more edible
- Using gelatins, ice creams, puddings, custards or milk shakes to replace hard-to-chew or hard-to-eat foods.
- Offering liquid or soft supplements (if appropriate) such as health shakes, Ensure or fortified cookies.
- If you see any of the following, tell your supervisor or health care provider depending on whether you are a professional caregiver or family caregiver:
- A change in the amount of assistance an older adult needs while eating.
- A change in general behaviors during mealtime such as playing with food, taking food from others, throwing food or falling asleep.
- A change in attitude such as withdrawing, showing anger or frustration.
- Choking while eating or drinking.
- Eating less or more food than usual.
- A refusal to eat.
Personal care assistance is so important with older adults. Keep in mind the fine line between being helpful and inhibiting their independence.