Our elder has several serious health conditions. The caregivers have to monitor her symptoms in order to tell us if they are getting worse. That takes a lot of work, and the information we need is extensive.
Chances are good that most elders who require 24/7 care will require similar information. To be on the safe side, make sure to check with your elder’s doctor to know what information to provide. Here is why we need the notebook and why you will probably also need one.
Agitation: When dealing with a dementia patient, agitation is the first sign that a problem is going to erupt. Many times this will be in the late afternoon and early evening. It’s called sundowning and it’s fairly common. However, sometimes agitation happens at other points in the day. We need to know when, why, the severity and what was done about it.
Blood Pressure: We need to know what our elder’s blood pressure is on a daily basis. This is for multiple reasons. Several of the conditions she suffers from can change her blood pressure. When it goes up, we need to know why (if possible) and if it was a one time deal.
Constipation: There are many medications that cause this condition, and when a multitude of them are taken it’s a given the issue will crop up. There are also ways of avoiding this issue. We need to keep track to make sure we are doing an adequate job of handling this problem, so a stool report is needed.
Kidney Output: Several medical conditions make keeping an eye on kidney output a necessity. If it decreases, changes in color or changes in smell, it needs to be reported. These may indicate a worsening of a medical condition that requires action.
Lack of Appetite: For us, this is going to be a sign that the end is approaching. Those who are in the active process of dying lose both appetite and thirst. Forcing food or fluids can actually cause them pain. The information on what, how much and when our elder eats will tell us when it’s time for us to be with her.
Pain Levels: Serious medical conditions can cause serious pain, especially as the end draws near. We need to know how often she is in pain and how bad it is. There is also the problem of the type of pain medication. There are several addictive medications in our elder’s pill planner and they have to all be accounted for. If one of the caregivers forgets to write down they gave her a pill it can cause several hours to work out what happened. If one gives our elder extra pain medication without authorization, the caregiver can’t remain in our employ. This is a major matter.
Sleep: One of the nurses told us that our elder would sleep more and more until one time when she doesn’t wake up. Notes on how often she dozes off and how long she remains asleep are important clues. This is another reason we require information about medications…many of them cause drowsiness. What we are looking for is how often she nods off without medication as the cause.
Verbal/Physical Aggression: Our elder has already developed verbal aggression. Thus far it hasn’t headed into physical aggression, but when it does it’s a game changer. Aggression is something we try to avoid…which is why we want notes on agitation. If we can stop this symptom at agitation by either words or medication, it is better for everyone.
There are other things in these notes. Sometimes it’s a comment on how another caregiver did or didn’t accomplish something. Sometimes it’s about a broken appliance. All of it is highly important, because we can’t be there every day to see for ourselves. This is why we need the caregiver notes.