[Nursing Care] ⑤ Risks and Countermeasures for Elderly Living Alone

When an elderly person lives alone and their cognitive and physical functions decline with age, various risks arise in their daily life. We want to manage and eliminate these effectively, don't we?

I think what constitutes a risk depends on each individual's situation, but...

For us, listing every minor risk in daily life from scratch was a difficult task, and we are still continuing to make improvements through trial and error.

With that said, I am sharing this for reference in case there are others going through similar hardships... (I will continue to maintain this as I gain more knowledge.)

Furthermore, such risk countermeasures can also end up restricting what the person requiring care can do. It is important to have the person fully understand this beforehand. Rather than just telling them, "Do this!" I think it is better to communicate with the mindset that nursing care is a collaborative effort between the caregiver and the person receiving care.

Fire Risk

Cooking, heating, hot water supply, bathing, electrical outlet tracking fires, etc. Since we already use only air conditioning for heating and only a gas water heater for hot water, I consider these to be zero risk. For bathing, she only uses the bath at the day service center and does not use the home bath (they were a family that didn't really take baths to begin with... Why do the elderly not take baths? Sorry if that's a prejudice 😅)

Therefore, the factors for fire risk were the following two points.

• Gas stove
  I had my mother understand the risk of fire and prohibited its use.
  Instead, I have her use the microwave effectively.

  1. Use of meal delivery services
     We use Watami's Takushoku "Magokoro Temari" and "Itsudemo Nisai." Bento boxes (side dishes only) are delivered from Monday to Friday for lunch. On days when she cannot receive them directly due to going to day service, they can be left in a cooler box at the entrance. It costs my mother about 17,000 yen per month. We were able to try a sample bento before starting the service, so we could check the portion size and taste, which gave us peace of mind.

  2. Microwave pan
     To meet my mother's request of "I want to eat grilled fish," I bought a microwave pan that can brown food in the microwave. The principle is that the heating element inside the pan heats up from the microwave's waves to grill the fish. My mother uses it well, for example, by placing raw vegetables under the fish to steam them, and other creative ways.

  3. Retort rice, retort porridge
     Since cooking rice is also a difficult task that takes time and effort, I switched my mother to retort pouches.

  4. Day service
     It goes without saying, but lunch is provided on days she attends day service.

  5. Helper / My shopping
     Since she needs to prepare two meals (breakfast and dinner) on days without day service, and one meal (breakfast) on days with day service, food for those meals must be kept in the refrigerator. Listening to my mother's requests, a helper does the shopping on Tuesdays, and I do the shopping and deliver it to my mother on Saturdays.
     (Also, I try to buy bulky items like toilet paper and paper diapers, and heavy items like milk and plastic bottles myself as much as possible, since they have a long shelf life, and I have told my mother this as well. Helpers come solely to support my mother's independence.)

• Outlets and Power Systems

  1. Outlet Box
     Since old houses are humid and dusty, I use 100-yen shop outlet boxes to cover power strips in places that aren't usually touched (= places where dust easily accumulates).

  2. Replacing Old Power Strips
     The warranty period for power strips is at most 5 years. After this, there is a risk of fire. My parents' house had a 30-year-old, yellowed power strip that I (presumably) used when I was a child, so I replaced it immediately.

Fall Risk

One day, I received a call from the care manager. The helper who visited found a bruise on my mother's arm, and when asked, she said she had fallen in the house that morning.
My mother said, 'I'm fine, I don't know why, but I just fell.' At first, I thought it was just a one-time thing, but then she fell and got injured two more times in quick succession.

No matter how much the person says, 'I'm fine, it was just a one-time thing,' what has happened once will definitely happen again.

After my mother hit her head on the corner of a piece of furniture and got a big bump, I took measures using baby corner guards.

Basically, you can buy these at 100-yen shops.

Below are two types that we actually use. Since they are baby products, the helpers and care managers didn't seem to know much about them and were surprised. (I guess this is what you call innovation, right? 😁)

Risk of Not Taking Medication

Until the summer of 2024, my mother couldn't take her medicine properly and had accumulated a whole convenience store bag full of it, but thanks to the following two improvements, she is now able to take it properly on her own.

• Have the pharmacy package them into single doses
  They package the medicine individually by date, name, and dosage.
  Originally, this is meant to reduce the risk of forgetting to take medicine by combining the three pills taken after a meal into one packet, but if you explain the reason, they can package even a single pill into one packet.
  
  When requesting single-dose packaging, you need to have the instruction written on the doctor's prescription, so please consult with yourdoctor. In our case, we said,
  
  'I need to take it to day service*, and I don't want to make a mistake with the dosage at home either, so could you please provide instructions for single-dose packaging?'
  
  We have never been refused so far.
  
  *Depending on the day service, some may ask you to 'please make sure the medicine is packaged in single doses.'
  *Some types of medicine, such as those sensitive to humidity, cannot be packaged in single doses, so please seek the judgment of your doctor or pharmacist. Specifically, Nailin capsules could not be packaged in single doses. (Added on 25.08.06)
  
  The slightly troublesome part is managing the dates.
  You need to grasp 'up to what date the medicine remains,' including the forgotten doses, and tell thepharmacy
  
  'Please package them starting from [Month/Day]'
  
  .
  However, if you don't say this, I think they will just date them assuming you will start taking them immediately after dispensing, so if you decide to discard the forgotten or duplicate doses, you don't necessarily need to manage it.

• Medicine Calendar
  I put the single-dose medicine packets into amedicine calendar for one week.
  I have her return the empty packets to the medicine calendar after she finishes taking them.
  I maintain this once a week.
  
  This allows my mother to take her medicine by herself, and I can check if there are any leftovers by looking at the empty packets. It also makes it easier for my mother to notice if she has forgotten to take any.
  
  My mother is prescribed medicine before and after every meal, so I use two calendars, one for before meals and one for after meals.
  
  Also, considering the ease of putting in and taking out the medicine, in my mother's case, it seems easier to use bags with some gusset, so after trying several types, we are currently using the following.

Risk of getting sick from eating rotten food

In my mother's case, she seems to have a tendency to forget things that have been hidden.
Vegetables buried at the bottom of the refrigerator's vegetable compartment are just forgotten and rot.
And the refrigerator's capacity keeps getting tighter and tighter.

So, whenputting things I bought into the refrigerator, I make sure to check with my mother if there is anything past its expiration date.I also ask the helper to check with her when they do the shopping.

I always make sure to leave gaps in the refrigerator to keep it easy to see inside. (Also to save on electricity bills)

Risk of making the house dirty

In my mother's case, she experienced incontinence, and as I mentioned earlier, we handled this using paper pants and paper pads.

However, if bedding gets soiled due to side leaks while sleeping, it is difficult to deal with once it soaks through.

After trying various waterproof sheets and covers for futons, I recently introduced pet sheets.I lay out newspaper-sized (super wide) sheets around the waist area of the bed, and slightly smaller (wide) ones on the floor chair.

If you have any better ideas, or if you do things differently, please let me know!!!

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