I think that we would all agree that breathing is essential to living.  When our bodies do not get enough oxygen, what happens? The most common reaction to a lack of oxygen is a sensation of panic, because our brain is very smart.  Our brains tell our lungs to respond with small, quick breaths to compensate for the feeling that we do not have enough air. Loss of oxygen and/or breathing problems make us pay a big price when it comes to our health.  One of the most common breathing problems is Chronic Obstructive Pulmonary Disease (COPD).

There are many places on the internet that explain the process of how oxygen is carried from the lungs throughout the body.  If you currently have breathing problems you know from your Priimary Care Physician and/or Pulmonologist that once your breathing problems start to affect your ability to function, they can no longer be ignored.  Your physician and treatment team have many medication options to choose from, with the primary goal being; to open up your lung capacity to breathe more easily.Some people think that if they take off their oxygen when they do activities and "test their lungs," that they do themselves a favor and are strengthening their lung capacity.  For most people the reverse actually happens.  The lungs have to work harder and the person becomes more fatigued.  If you have been told to wear your oxygen for a certain number of hours per day, or specifically when you are doing activity, please follow your physician's advice.  Not wearing your oxygen does not make your lungs stronger.  It makes you feel weaker.My concern is your ability to function (as always).  What type of functional limitation do breathing problems impose on you?  The most annoying limitation that patients complain of is Fatigue or Decreased Energy.  It makes sense though.  With a decrease in your ability to oxygenate your body; your muscles, nerves, brain and all vital organs do not get to the same level of strength you used to have.  So the plan to manage these conditions functionally is to CONSERVE ENERGY.You need to conserve the energy you do have, and not waste it all on the necessary activities you HAVE to do, but try to save some energy for the things that you LIKE to do.Please realize that your physician and treatment team know your needs better than I do, and this advice NEVER should take the place of what you have been told to do by them.  But, here's what I want you to try.  I want you to modify your approach to your Activities of Daily Living (ADL'S). We call this; Using Energy Conservation Techniques.

This is something that most Occupational Therapists preach to their patients.  Some listen and some don't.  I am just asking you and your care-partner to try a few of these ideas and see if they help:   

Start out by preparing your area:

Get your underwear, clothes, (including shoes and socks) 2-3 hand towels, shampoo, soap and any other things you need.    
     
      1.  Sit to shower. (Look under the HOME MANAGEMENT TAB for specific equipment ideas)

      2.  If you are on oxygen, wear your oxygen in the shower; remove the nose piece to wash your face, but otherwise keep it on.

      3.  Have your towel within easy reach of your seated position, and stay seated to dry off. *  Use 2 or 3 small hand towels to dry
          off instead of one large towel.  They are easier to manage and require less strength to use.

     4.  If you don't already have grab bars in your shower, you need to have at least 2 installed. 

         Refer to the HOME MANAGEMENT SECTION for more ideas on Home Safety. 

    5.  Place a chair in your sink area, that has a back and arms (not a stool) and SIT to shave, groom, apply make up and brush your teeth.*

    6.  Put your clothes on SITTING DOWN.   STAND ONLY TO APPLY YOUR UNDERWEAR AND PANTS.

         *   If you are on oxygen; wear it throughout all of these steps, only removing it when it is in the way.Once you have completed all of these steps, see if you feel less tired than you normally do.  If so, it is just because standing requires energy and consumes more oxygen than sitting.  Now, the goal is that you should be able to spend your extra energy doing something that is more enjoyable than just getting dressed and showering...."Now let's get going!" 
                                                             

 If you would like to learn more about Sally Thimm OTR/L Occupational Therapy Services visit: Professional Case Management of SWFL

Alzheimer's Disease (AD) is a very challenging disorder that affects the brain's nerve cells.  Many brain functions can become impaired in the process.  Thinking skills, memory, and the development of behavioral changes are often the most obvious symptoms of the disease.  Due to our aging population in the United States, this disease has been recognized as having a major impact on our social and healthcare systems.

There are stages of this disease where the symptoms can be mild, and a person may have functional limitations with their short term memory for example, and then there are those cases that evolve into a person requiring one on one care and monitoring 24/7, to avoid problems with safety in the home. Many informational resources are available on line. Some counties offer support groups and adult day care programs.  If you do not have resources in your area we can try to help you locate options closest to you.  The following list of suggestions may help you manage the care of a person with memory problems.  Also look for specific suggestions under the Home Management Tab, associated with ways to assist a person manage their ADL's (Activities of Daily Living. ie. bathing, dressing and/or self care), when they have dementia.

1. Routine - Try to stick to a routine when managing daily activities.  It helps the patient identify what is expected of him or her and can make the outcome more successful.  Try to consistently approach activities the same way; getting into the shower, getting out of the shower, sitting on the same seat to dress, etc
2. Rituals - Maintain habits that the patient has had. If the patient showers every morning before breakfast, try to continue that habit. Changes to long standing behaviors can cause confusion and fear.
3. Reassessphysical health if there is a behavioral change. Many times people can demonstrate more confusion or agitation when they have a physical change.  A UTI (Urinary Tract Infection) is a good example of a physical change that can inadvertently cause a behavioral change.  *Just because a person has dementia, or is labeled with a disease like Alzheimer’s, it does not mean that they won't continue to have colds, urinary tract infections, the flu, cardiac changes, etc..
4. Redirector change a person from repetitive thought patterns. If a person asks you "When can I go home?" (whether they are home or not), you can offer the person another activity to do or a snack.
5. Real questions-may be difficult to decipher if the person with AD has difficulty communicating.  Increased agitation, for instance could be his or her way of telling you a trip to the restroom is needed.  Learn to read body language.
6. Reconsider the behavior. Is it really a problem, or is it just upsetting to you?  Does it present a danger to the person with AD? If the person talks to his or her reflection in a mirror as if it was another person, is that a real problem?  Does it please the person with AD or does it upset or frighten him or her?
7. Respect the person with AD. Laugh with, not at the person.  Never talk about the person as if he or she is not there.  And remember, the person with AD will know how you feel by your body language and tone of voice.
8. Reassure the person with AD often that you love and will care for him or her.  A gentle pat, stroking the hair, or holding a hand all say, "I care for you."
9. Remember the person with AD is still a human being. Treat him or her the way you would want to be treated if you were suffering from dementia.

Managing a loved one with AD or dementia requires patience and commitment.  The caregiver needs to recognize their limits and work on establishing ways to care for themselves as well.  It is very hard to provide care for someone if the caregiver is tired and overwhelmed. Make sure that the caregiver is well cared for too! 

Find some helpful ideas under Care-Partner's Corner section of our website !  Now Lets Get Going!  xo - Sally                      

If you would like to learn more about Sally Thimm OTR/L Occupational Therapy Services visit: Professional Case Management of SWFL