Tuesday, September 05, 2006
what to take to a retirement home
This is a strange idea for a blog post, but it's a subject I think about almost every day. Because my work experience as a nursing assistant has primarily been in assisted living facilities, I have seen a very wide variety of choices of clothing, accessories, furniture, keepsakes, and so on in residents' rooms. As a caregiver, I've developed some opinions about what kinds of things are really helpful, and what kinds of things are more trouble than they're worth.
Clothes:
Oddly enough, the problem I see most often in this area is the resident having too many clothes. If the resident brings their entire lifetime wardrobe to the facility, there will not be enough room for everything, and it will be very difficult to find clothes for them to wear. I know it's sometimes hard to get rid of things... but it really doesn't do the resident any good to have a closet crammed full of clothes they'll never wear. For example, I used to work with a lady who had three pairs of pants that fit her, a couple of skirts and a couple of dresses that fit, and then half of a closet full of clothes that didn't fit or were never appropriate. This lady was never going to need a choice of 5 dress coats again. Nor was she going to require a ball gown, 5 business suits, nor a fur coat.
Which brings me to my next point - make sure that the clothing the resident has actually fits! I can't tell you how many times I've tried to help a resident get dressed and discovered that their pants are too small, their sweater won't button, or their bra won't fasten. Often family members are in denial about the changes their loved one is experiencing - such as a woman I care for who was very petite for most of her life, but has gained a great deal of weight in the past few years, and also has issues with edema in her legs. A lot of her clothes are too small and even when her family members bring in a new item of clothing, they still buy a size small or medium because that's what she used to wear. Another factor in clothing sizes is the use of incontinence products - if a resident wears Depends/briefs/pullups/pads, those products take up a lot of room inside the clothing, and the resident may need pants that are a size bigger. Even if the pants still fit around the resident's waist, if they're not quite big enough, the Depends will show through the pants and that's embarrassing.
Lastly, I can't stress enough how important it is to have flexible, easy-to-wear clothes for residents. Even residents who are able to dress themselves without difficulty will often wear the same one or two outfits over and over because they're the easiest to put on and take off. And when the resident requires assistance to get dressed, it's even more important to have clothing available that is easy to get on and off. This means shirts with neckholes big enough to get over the resident's head easily, sleeves that aren't so tight that the caregiver has to yank the resident's arm off to get the sleeve past the elbow, pants with elastic in the waist (those comfort fit dress pants with the elastic sections are great for men!), socks that are not too tight (except for compression stockings of course), shoes that are easy to step into, comfortable pajamas that are easy to remove for toileting, slippers and bathrobes for trips to the toilet or the shower, and layering options because the elderly are more sensitive to temperature changes. If there was one item I could give every one of my residents, it would be a loose cardigan that buttoned or zipped all the way up to the neck, in a neutral color so it would go with any outfit, in a durable machine washable fabric. And if I could add another, it would be a full-length terrycloth robe that I could wrap around a wet resident just out of the shower so they wouldn't have to stand on the bathmat shivering while I towel them off. Oh yeah, PLEASE don't take any clothes that have special cleaning requirements. Caregivers do laundry constantly, and frankly we are too busy to deal with hand-washing, dry-cleaning, or drip-drying. Everything needs to be able to go into the washer and the dryer.
In a perfect world, the resident's clothes would all be in the same group of colors, so that they would look decent no matter how their clothes were combined. For example, I take care of one resident who has several pairs of black pants and a lot of blouses in bright colors or patterns. She looks nice every day because her clothes work even if chosen at random. Another woman I care for has several pairs of neutral colored pants and shirts and sweaters in pastel colors. She always looks pretty, too.
Clothes and linens should be labeled with the resident's name (and maybe room or bed number). Labels like this work great. For residents who have their laundry done by the facility, labeling helps make sure that clothes are returned to the correct resident. It's useful for residents who are independent as well - if they leave their sweater in the dining room, it will get returned.
Shoes:
Believe it or not, shoes are a huge deal. Most residents have very sensitive feet and need several functions from their footwear: stability, support, cushioning, pressure prevention, and comfort. It's very common for older people to develop pressure sores on their feet from shoes that are too tight or too stiff - and these sores take a long time to heal. Many residents who are wheelchair dependent don't wear shoes at all, but wear slippers (like these) to keep their feet warm and comfortable. Most residents also enjoy wearing slipper socks in bed - fuzzy socks with rubberized "treads" on the bottom for secure footing.
Accessories:
As a caregiver, I would like all my residents to have a comb & hairbrush (and lots of barrettes/combs/elastics for women who wear their hair up), a couple of toothbrushes and whatever denture care items they need (don't make your mom keep her teeth in a glass of water for lack of a denture cup!), a couple of glasses or cups for the bathroom, extra hearing aid batteries, a spare pair of eyeglasses if possible, and for men, an electric razor. Yes, I know a lot of men have always shaved with shaving cream and a razor. But now that I'm going to do it for him, I will do a much better job with an electric razor, and his face won't get cut accidentally even if he wiggles. If the resident's pants fall down (we see this often with men who tend to lose some weight around the middle as they age), please make sure they have a sturdy belt that will look okay with any outfit.
Some facilities provide sheets and towels for resident use, others do not. If your facility doesn't provide linens, bring at least three sets of sheets (preferably interchangeable in color/pattern) and three sets of towels (bath towel, hand towel, washcloth). An extra blanket and/or bedspread is also a good idea in case one gets soiled. If there is any risk at all of incontinence, a mattress protector and several incontinence pads are invaluable. One or two machine-washable throws or lap blankets are nice too - they are easy to tuck around a cold resident who is seated, or to put over a resident who is lying down for a nap.
Pillows are frequently overlooked but are important to have. Not only do we use a pillow under a resident's head while sleeping, we use them for positioning a resident on his/her side, to brace them in bed to preven them from rolling off the edge of the mattress, to elevate puffy legs, to make a chair or wheelchair seat more comfortable, to relieve pressure on an aching back, to prop up a resident who is weak on one side, and on and on. Three pillows is a good number to have on hand.
Furniture:
Most assisted living facilities and even some nursing homes encourage residents to bring their own items of furniture. It's hard to choose what to take to a small apartment, especially when the resident may be moving out of a large family house. It's very common for rooms to be overcrowded with lots of furniture that the resident never uses. I would suggest bringing a twin-size bed (ideally an adjustable bed), one dresser, the resident's favorite comfortable chair, and some kind of table or stand for a TV or radio. Other items that may be useful are an end table to put next to the comfortable chair, a bookshelf, a desk if the resident will use it, or a footstool. Some of the items that I've seen in residents' rooms that never seem to get any use are: dining tables & chairs, multiple bookshelves filled with old books or knick-knacks, musical instruments (I've seen pianos crammed into studio apartments!), sewing tables with sewing machines, full-size couches, desks full of papers and office supplies, china cabinets, coffee tables, grandfather clocks, and so on.
As for knick-knacks and decorations, I think it is wise to choose the most sentimentally valuable items and leave the rest. I cared for a woman (the one with 5 dress coats) who had two enormous floor-to-ceiling bookshelves full of her lifetime collections of dolls, teacups, small statues, decorative plates, and on and on. She never looked at any of it. The type of items that residents seem to enjoy having in their rooms - even if they have memory loss - are framed family photos, a favorite painting/portrait/artwork, photo albums, and handmade items like afghans, quilts, rugs, and so on. Many residents with dementia enjoy having a favorite doll or teddy bear in their room. One of my residents carries around her childhood teddy and tells everyone that her daddy gave it to her when she was 5. It's obviously enormously comforting to her.
Okay, I think that's my entire brain dump. So, to recap!
Clothing:
easy to put on and take off, correct sizes, coordinating colors
machine washable and dryable
not too many clothes, only what's needed
plenty of pajamas or nightgowns
frequently used items like bathrobe, cardigan, slippers, bed socks
comfortable, sturdy shoes that don't cause pressure sores
OR
study slippers
labels on clothing with resident's name
Accessories:
comb & hairbrush, and hair accessories for women
a couple of toothbrushes, denture care items, and glasses or cups for the bathroom
extra hearing aid batteries
spare pair of eyeglasses
electric razor for men
3 sets towels and 3 sets sheets if not provided by facility
mattress protector and incontinence pads
3 pillows
Furniture:
twin-size bed, preferably adjustable
favorite comfortable chair
dresser
optional according to resident preferences: end table, bookshelf, desk, footstool
a few treasured keepsakes, family photos (framed or in albums), a favorite portrait or artwork, a favorite doll or teddy bear
handmade items like afghans or quilts
I hope this helps someone. I would gladly edit this post to accomodate suggestions any readers may have.
Clothes:
Oddly enough, the problem I see most often in this area is the resident having too many clothes. If the resident brings their entire lifetime wardrobe to the facility, there will not be enough room for everything, and it will be very difficult to find clothes for them to wear. I know it's sometimes hard to get rid of things... but it really doesn't do the resident any good to have a closet crammed full of clothes they'll never wear. For example, I used to work with a lady who had three pairs of pants that fit her, a couple of skirts and a couple of dresses that fit, and then half of a closet full of clothes that didn't fit or were never appropriate. This lady was never going to need a choice of 5 dress coats again. Nor was she going to require a ball gown, 5 business suits, nor a fur coat.
Which brings me to my next point - make sure that the clothing the resident has actually fits! I can't tell you how many times I've tried to help a resident get dressed and discovered that their pants are too small, their sweater won't button, or their bra won't fasten. Often family members are in denial about the changes their loved one is experiencing - such as a woman I care for who was very petite for most of her life, but has gained a great deal of weight in the past few years, and also has issues with edema in her legs. A lot of her clothes are too small and even when her family members bring in a new item of clothing, they still buy a size small or medium because that's what she used to wear. Another factor in clothing sizes is the use of incontinence products - if a resident wears Depends/briefs/pullups/pads, those products take up a lot of room inside the clothing, and the resident may need pants that are a size bigger. Even if the pants still fit around the resident's waist, if they're not quite big enough, the Depends will show through the pants and that's embarrassing.
Lastly, I can't stress enough how important it is to have flexible, easy-to-wear clothes for residents. Even residents who are able to dress themselves without difficulty will often wear the same one or two outfits over and over because they're the easiest to put on and take off. And when the resident requires assistance to get dressed, it's even more important to have clothing available that is easy to get on and off. This means shirts with neckholes big enough to get over the resident's head easily, sleeves that aren't so tight that the caregiver has to yank the resident's arm off to get the sleeve past the elbow, pants with elastic in the waist (those comfort fit dress pants with the elastic sections are great for men!), socks that are not too tight (except for compression stockings of course), shoes that are easy to step into, comfortable pajamas that are easy to remove for toileting, slippers and bathrobes for trips to the toilet or the shower, and layering options because the elderly are more sensitive to temperature changes. If there was one item I could give every one of my residents, it would be a loose cardigan that buttoned or zipped all the way up to the neck, in a neutral color so it would go with any outfit, in a durable machine washable fabric. And if I could add another, it would be a full-length terrycloth robe that I could wrap around a wet resident just out of the shower so they wouldn't have to stand on the bathmat shivering while I towel them off. Oh yeah, PLEASE don't take any clothes that have special cleaning requirements. Caregivers do laundry constantly, and frankly we are too busy to deal with hand-washing, dry-cleaning, or drip-drying. Everything needs to be able to go into the washer and the dryer.
In a perfect world, the resident's clothes would all be in the same group of colors, so that they would look decent no matter how their clothes were combined. For example, I take care of one resident who has several pairs of black pants and a lot of blouses in bright colors or patterns. She looks nice every day because her clothes work even if chosen at random. Another woman I care for has several pairs of neutral colored pants and shirts and sweaters in pastel colors. She always looks pretty, too.
Clothes and linens should be labeled with the resident's name (and maybe room or bed number). Labels like this work great. For residents who have their laundry done by the facility, labeling helps make sure that clothes are returned to the correct resident. It's useful for residents who are independent as well - if they leave their sweater in the dining room, it will get returned.
Shoes:
Believe it or not, shoes are a huge deal. Most residents have very sensitive feet and need several functions from their footwear: stability, support, cushioning, pressure prevention, and comfort. It's very common for older people to develop pressure sores on their feet from shoes that are too tight or too stiff - and these sores take a long time to heal. Many residents who are wheelchair dependent don't wear shoes at all, but wear slippers (like these) to keep their feet warm and comfortable. Most residents also enjoy wearing slipper socks in bed - fuzzy socks with rubberized "treads" on the bottom for secure footing.
Accessories:
As a caregiver, I would like all my residents to have a comb & hairbrush (and lots of barrettes/combs/elastics for women who wear their hair up), a couple of toothbrushes and whatever denture care items they need (don't make your mom keep her teeth in a glass of water for lack of a denture cup!), a couple of glasses or cups for the bathroom, extra hearing aid batteries, a spare pair of eyeglasses if possible, and for men, an electric razor. Yes, I know a lot of men have always shaved with shaving cream and a razor. But now that I'm going to do it for him, I will do a much better job with an electric razor, and his face won't get cut accidentally even if he wiggles. If the resident's pants fall down (we see this often with men who tend to lose some weight around the middle as they age), please make sure they have a sturdy belt that will look okay with any outfit.
Some facilities provide sheets and towels for resident use, others do not. If your facility doesn't provide linens, bring at least three sets of sheets (preferably interchangeable in color/pattern) and three sets of towels (bath towel, hand towel, washcloth). An extra blanket and/or bedspread is also a good idea in case one gets soiled. If there is any risk at all of incontinence, a mattress protector and several incontinence pads are invaluable. One or two machine-washable throws or lap blankets are nice too - they are easy to tuck around a cold resident who is seated, or to put over a resident who is lying down for a nap.
Pillows are frequently overlooked but are important to have. Not only do we use a pillow under a resident's head while sleeping, we use them for positioning a resident on his/her side, to brace them in bed to preven them from rolling off the edge of the mattress, to elevate puffy legs, to make a chair or wheelchair seat more comfortable, to relieve pressure on an aching back, to prop up a resident who is weak on one side, and on and on. Three pillows is a good number to have on hand.
Furniture:
Most assisted living facilities and even some nursing homes encourage residents to bring their own items of furniture. It's hard to choose what to take to a small apartment, especially when the resident may be moving out of a large family house. It's very common for rooms to be overcrowded with lots of furniture that the resident never uses. I would suggest bringing a twin-size bed (ideally an adjustable bed), one dresser, the resident's favorite comfortable chair, and some kind of table or stand for a TV or radio. Other items that may be useful are an end table to put next to the comfortable chair, a bookshelf, a desk if the resident will use it, or a footstool. Some of the items that I've seen in residents' rooms that never seem to get any use are: dining tables & chairs, multiple bookshelves filled with old books or knick-knacks, musical instruments (I've seen pianos crammed into studio apartments!), sewing tables with sewing machines, full-size couches, desks full of papers and office supplies, china cabinets, coffee tables, grandfather clocks, and so on.
As for knick-knacks and decorations, I think it is wise to choose the most sentimentally valuable items and leave the rest. I cared for a woman (the one with 5 dress coats) who had two enormous floor-to-ceiling bookshelves full of her lifetime collections of dolls, teacups, small statues, decorative plates, and on and on. She never looked at any of it. The type of items that residents seem to enjoy having in their rooms - even if they have memory loss - are framed family photos, a favorite painting/portrait/artwork, photo albums, and handmade items like afghans, quilts, rugs, and so on. Many residents with dementia enjoy having a favorite doll or teddy bear in their room. One of my residents carries around her childhood teddy and tells everyone that her daddy gave it to her when she was 5. It's obviously enormously comforting to her.
Okay, I think that's my entire brain dump. So, to recap!
Clothing:
OR
Accessories:
Furniture:
I hope this helps someone. I would gladly edit this post to accomodate suggestions any readers may have.
Comments:
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I would think that every retirement home, nursing facility and assisted living place would print this out and hand it to prospective resident's families along with the other info brochures! What a practical bunch of information. We only did a few things wrong with Granny!
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# posted by 
: September 09, 2006 1:41 PM
: September 09, 2006 1:41 PM << Home
