Older Singaporeans who need assistance are growing in number each day. By 2030, the Academy of Medicine Singapore predicts that half of those who need help would have difficulty with three or more ADLs. To be better prepared to care for ageing loved ones, caregivers need to know the basics of assisting.
This guide will lay out the things you’ll need to know – from tips on ADL assistance to assessments for caregiving grants, all the way to the different care options for your loved ones.
Activities of Daily Living (ADLs) is a term used by elderly care professionals to determine a person’s ability to live independently and test their ability to perform basic self-care tasks. These are 6 tasks that are learned from a young age and are usually done daily without assistance. But with age, some may lose the ability to perform these independently. Among such tasks are eating, grooming and using the toilet.
On the other hand, Instrumental Activities of Daily Living (IADLs) are tasks that require more organization and critical thinking skills. These activities go beyond basic self-care and not all independent seniors are capable of doing it. Examples are cooking and preparing meals, housekeeping and managing finances and medication. Elderly loved ones may look to others for help in these activities.
6 activities of daily living determine a person’s independence. As our loved one’s age, they may need assistance with more than one. As primary care givers, it is good to know how to assist our loved ones correctly.
Caregivers should always be nearby to provide assistance. However, there may be instances your loved one would want to assert their independence and do things on their own. Encourage them to continue exercising their independence as this helps build their confidence and helps them stay engaged and active.
Upkeep of hygiene is an essential self-care activity done that is done regularly. It includes basic grooming, oral care and washing or the ability to bathe or shower independently. For seniors who have problems with balance, simply stepping in and out of the bath or shower may prove difficult or even dangerous.
When assisting your loved ones with their hygiene, their safety and comfort is a priority. It would be good to invest in a shower chair or non-slip mat to prevent accidents. You can also help them establish a routine by putting on the music they like, ensuring the availability of warm water and laying out clean clothes for them after they come out of the bath. For those that require more support, consider hiring a professional to help your loved one with their hygiene.
Toileting involves sitting and rising from the toilet as well as cleaning yourself after. Some seniors may be susceptible to falls while others have lost control over their bowel and bladder function.
To assist with toileting, a caregiver can accompany them each time they need to relieve themselves. Another option is using protective undergarments such as diapers for seniors who find it difficult to go to the toilet and have trouble controlling their bowel movements.
Dressing entails not only choosing clothes and wearing them properly but also putting on medical and surgical appliances such as braces or artificial limbs. It may be difficult for elderly loved ones with conditions like arthritis or dementia to do this alone and so they may need a helping hand when dressing.
When helping your loved ones dress up, pick loose clothes with elastic waistbands to ensure maximum comfort. When it comes to footwear, it would be good to consider getting non-slip shoes with front fasteners to reduce the risk of falls.
Feeding is the ability to feed oneself food that has been prepared. Due to difficulties in swallowing, problems with motor skills or cognitive impairment, some seniors find it hard to feed themselves. While others may even completely forget to eat.
In helping your loved ones eat, remove any distractions so you can get their focus. Ensure they are seated comfortably as you guide them through the steps of eating through verbal and physical cues (i.e pick up the spoon, scoop some soup). You can also invest in adaptive feeding devices such as a nosy cup which will help reduce spillages while weighted utensils can help stabilize tremors when picking up food.
Functional mobility does not only involve walking, it is required in all 6 activities of daily living. From standing and walking to shifting positions on the bed, some seniors may need assistance especially if they experience some physical pain or discomfort.
If your elderly loved ones show signs of mobility issues, it would be good to have them visit the doctor to understand the issue. Some who experience mobility difficulties may lose their confidence in performing daily tasks so it is good to encourage them to stay active. This can mean encouraging them to continue their daily routine or keeping them company as they go through exercises prescribed by their doctor.
Another tip is to try simplifying routine activities and perhaps even enlist an occupational therapist that can give instructions in using mobility devices.
Transferring refers to moving from a resting position on the bed to sitting on an upright chair or wheelchair and vice versa. There may be some seniors who have problems with balance or coordination or may have a physical impairment that requires them to be carried.
Before you try picking up your loved one, it would be wise to learn first the proper ways of carrying to avoid hurting both them and yourself. Some elder care services provide instructions on proper carrying techniques along with other care tips to their client’s primary caregivers.
Investing in the necessary equipment will make a big impact in improving your loved one’s quality of life and ensuring that their environment is safe, accessible and serves their best interests. This equipment may fall into one of the following categories.
Balance Aids such as grab bars and railings.
Mobility Aids such as walkers, wheelchairs, crutches, ramps and chair lifts.
Medical Aids like earing aids and medical alert devices.
Tools for dressing like buttoning aid hooks and hands-free shoes
Tools for bathing such as handheld showerheads, washcloth mitts, shower chairs and anti-slip mats
Cooking and preparing food
This requires focus, balance as well as dexterity. Elderly people who get distracted or tired easily will be unable to prepare daily meals for themselves and may require additional help.
Companionship is necessary to maintain well-being and mental health. Caregivers provide elderly loved ones with companionship as well as focused professional care.
Maintaining a clean home requires energy and strength and this may be too much for your loved one. Enlisting a helper can take over the responsibility of domestic chores such as cleaning the house and doing laundry. They will ensure your loved ones are living in a safe and comfortable environment.
Transportation and Shopping for essentials
Delivery and escort services are available for seniors who have a hard time shopping for their needs themselves.
Managing Finances and Medication
Elderly loved ones may need help making financial decisions for themselves. It may be difficult for them to remember to pay bills or even take their medication on time and as such would need assistance.
To apply for government schemes that can help defray the cost of elder care services (such as the Caregiving Grant and Foreign Domestic Worker Levy Concession), your loved one needs to undergo an assessment.
The Functional Assessment Report (FAR) assess a person’s need for assistance with basic activities. It is typically conducted by an occupational therapist and can be done in your home or at an elder care facility.
Alternatively, your loved one’s doctor can provide a document certifying the patient’s condition is bedridden and this can be used instead of the FAR.
For those applying for a severe disability scheme such as the CareShield Life, Elderfund and Eldershield, you will need a MOH-accredited severe disability assessor to complete the Assessor Statement
Once the assessment determines that your loved one needs assistance, it is time to get to know the care options available for your loved one.
For loved ones who prefer to stay in a familiar home environment, in-home Caregivers and Home Nursing Care Singapore can provide the assistance they require. They can provide support for your loved one’s daily routines and other daily living ADLs with professional care and medical attention.
Nursing homes are a good alternative as well. They have round the clock care and care staff can assist in both ADLs and IADL needs. A nursing home also provides recreational and social opportunities for its residents.
Another appealing option is a Senior Retirement Village. The Singapore Retirement Village are communities were designed to provide elderly care and support for their residents as well as include them in social activities to help foster a sense of community and belonging which will improve their well being and overall health.