photo: Martha G. Brady

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Safety is an important consideration for you if your loved one has any impairments. It makes no difference if they are physical, mental or emotional. You need to understand what his limitations are as well as to provide a safe environment for him. If he has certain types of brain damage, he may not have good safety awareness anymore. Sometimes, you need to remind him and he does fine. Other times, it does no good.

Part of providing a safe environment means removing scatter rugs, clearing away clutter in your house or apartment, making areas such as halls, that are narrow, as wide as possible for getting around in. (Removing things that block them as well.) Falling is a large area of concern when we have an unsteady or weak person in the home. Falls can complicate recovery times or add pain and distress to healing times. They can also kill in extreme cases.

Sadly, we can provide as safe an environment as possible, but we aren’t always able to prevent every single fall. It all depends on the person we are working with. Some are so impulsive, we just can’t keep up with them apart from using restraints…and that isn’t always a practical solution. We simply need to provide as safe of an environment as possible. We do as much watching as we can. But we also have other responsibilities and they have to get done as well.

Finding the balance between what we can afford/what insurance will pay for, what we can physically do, how much family help we are able to get equals the level where we will be able to function in terms of safety. It may not be at our personal favorite level. But it is what we will have to live with.

When we talk about safety, we are also talking about keeping the caretakers safe!

Another aspect of safety involves safety for you! You need to be careful that you don’t injure yourself. Often, part of his rehab will be in helping you learn how to move him or lift him in ways that will not injure you! At this point, I can’t go over all the things to consider…keep your back straight, keep your legs bent, etc. because it all depends on what has to be done.

You will soon learn that once someone is already on the floor, they are safe. You don’t need to endanger yourself by impulsively grabbing them up! You can take some time to get help to get them up off the floor. It may mean a neighbor or two or some friends. Or it may mean calling an ambulance. You don’t want to get a back injury in the process of caring for him…or fall and break a bone because you weren’t being safety-aware.

Information about gait belts and why you need to know about them!

If your loved one needs help moving, I highly recommend the belt pictured above. It is called a gait belt or transfer belt. It looks like it shouldn’t be as helpful as it is, but it is a great and cheap piece of equipment! We used them all the time in rehab. Patients didn’t always like them, but if you are caring for someone who needs lifting, is weak on one side, is a dead weight, etc., you need one of these at least, to protect your back. If they have a tendency toward incontinence, buy two so one can be washed. If you are able to get out and about, buy two so you can have one in your car and one at home in case of falls.

It is for the patient to wear. It is helpful to prevent a fall because you have something to grab if he starts to fall. If he falls and doesn’t have one on, you can put it on him easily and have something to hang onto to pull him up or have another person help you in pulling him up. Once you get used to them, you will love them. They come in a variety of colors and belt types, but I like the ones with metal buckles. You will want one with some extra length to it in case it has to go around something bulky in addition to the person’s waist. I see they have a plastic buckle, but I’m not sure they would be as durable as the metal buckles.

These belts are especially helpful for the family member who is recovering from a stroke or is weak in some way, even if he has a walker. They help you if he has a tendency to get off balance or start to fall. You can manage him with one person and often prevent a fall if he has the belt on. They are also helpful for the person who is losing ground and is starting to fall when he hadn’t been before.

There are other aspects to safety, but falling is a huge part of safety. Thinking ahead about making it a safe place for him helps you look around your home and the other places your loved one where he is active.

What do you do if your loved one has trouble swallowing or choking?

Another area for safety has to do with swallowing/choking. For some, it isn’t an issue, for others, they have to be very careful. Some strokes or brain injuries leave people so they need to have their liquids thickened, at least at first. By the time you leave the hospital, you will know what category you fall into.

If your loved one has issues with swallowing, you need to be sure they are sitting up when they eat or drink. They need to eat slowly and take small bites. Meals can’t be rushed. It may be trying if you are someone who likes to get meals over and done with. It may help to bear in mind that if food or drinks get aspirated (go to the lungs instead of the stomach) you could be dealing with pneumonia! That can be a nerve-wracking responsibility until you get used to it. This can gradually become more of a problem for people with Parkinson’s and other degenerative diseases. Usually, it happens gradually, so you adjust as time goes by at a slow rate.

If your loved one has trouble with swallowing or is likely to choke, you would be wise to learn how to use the Heimlich Maneuver. (Click on the photos and they will show up larger.) If he is choking, you need to know how to use it or its variations. Then, if there is a choking spell, you can use it and make a scary situation less so.

Dealing with seizures…less common of a problem, but still present.

I think I’ll also tuck in here how to deal with seizures for safety as well. There are so many ways people feel they can help here and often ways they have heard they should help that are no longer the right ways to help…at a time when you feel very helpless! For small seizures like absence seizures or focal seizures that affect only one part of the body like an arm or a leg, the seizure may pass before you even realized it happened.

With a grand mal seizure that is not the case. This is a convulsion basically. There is no mistaking what has happened. The person loses consciousness and often is unconscious for a while after. Calling an ambulance is rarely needed unless this is the first one they have had. But if they have a degenerative neurological disease, it may not be unexpected. It may be something you have discussed with your doctor and have decided what needs to be done when the first one happens.

Generally, the only reason you would need to go to the ER, is if there was an injury such as a fall that was severe enough that a bone might have been broken, cuts that might need stitches or the likely possibility that a CT scan is needed to rule out a head injury (from a fall). (This happened to me once when I was on a sidewalk and fell really hard on the side of my head. I had bruises for nearly a month after and probably had a concussion from it. Fortunately, that was all! )

There was a time when we were told to put something in their mouth to keep them from biting or swallowing their tongue. It is highly unlikely they will swallow their tongue. When a seizure starts, they clamp down on their tongue and the ability to avoid chewing their tongue is almost impossible! By trying to open that clamped down mouth, you are likely to get yourself bit. Don’t even go there. Turn them to their side so their tongue doesn’t block the airway. Any bleeding or fluids in their mouth can drain. Don’t try to restrain their arms or legs from moving. You could add to their injury. Just protect them from being injured. Rather than simply some bruising, they could have a joint dislocated, maybe even a broken bone. When the seizure has stopped, you may want to lay a light blanket on top of them. It is not a good idea to give oxygen during a seizure because some many seizures are stopped when the O2 level drops…so that might simply extend the seizure.

I think I have touched on some of the high points of safety in the home, for caretakers. If you have some other areas you would like mentioned, ask me. I’ll add them later. These are some of the main ones. Overall, we learn to depend on GOD at this time, to protect us and care for us. But it helps our stress level to be aware of a few simple precautions.

In peace I will both lie down and sleep;
    for you alone, O Lord, make me dwell in safety.

Psalm 4:8

 

The Lord will rescue me from every evil deed and
bring me safely into his heavenly kingdom.
To him be the glory forever and ever. Amen.

II Timothy 4:18