A a child caregiver, your daily work can be physically and emotionally exhausting. If you also are a caregiver outside of work for an aging parent or a chronically ill or disabled person, the demands placed on you can seem overwhelming. People with chronic illnesses or disabilities present unique challenges and as a caregiver, you can face some difficult situations. For example, what do you do when special meals are required or bathing is difficult? Practical solutions for some of these difficulties can help alleviate your own stress and improve the quality of life for both you and the person in your care. Every situation is different, so here are some ideas you can use or modify to fit your particular needs.

Special Meals: People may require special meals for various reasons, including nutritional needs, because of chewing or swallowing difficulties, or simply because of loss of appetite. Ask the person what she likes to eat. If some of her favorite foods are not on the prescribed diet, try to substitute similar food items that are allowed. This not only helps you plan the menu, it also may create a more cooperative situation because the person feels you care about her feelings and opinions. If the person lives with you, try to plan her meals in conjunction with yours or the rest of the family, both in food preparation and eating times. For example, you may prefer vegetables raw or crisp-cooked, but usually it is relatively easy to cook a serving of the vegetable longer to accommodate a person with chewing and swallowing difficulties. By preparing one meal for everyone, with small variations as needed, you may save time and help to make the person you care for feel more comfortable and welcome.

Bathing Physical limitations or simple lack of cooperation can make bathing difficult. First, find out why bathing is a problem for the person:

• Is it because they are modest and are embarrassed to be undressed with someone else around? If so, find a short, lightweight wrap robe to wrap around them while they bathe.
• Is it because they are unable to regulate the water temperature properly and safely? If so, set the water temperature for them and let them run their hand under the water to test it before they get in. Remember that older people, like children, have tender skin and slower reaction times and can suffer severe burns from water more than 120 degrees Fahrenheit.
• Is getting in or out of the tub or shower difficult? Consider a bathing chair that can be placed in the tub and/or install handrails. If those things do not help, the answer may be to just give sponge baths.

If a person in your care is resistant to bathing for no reason in particular, ask their physician to write a "prescription" for bathing. He or she might respond to an official directive from the doctor when they will not listen to you!

Bathrooms are places where injuries can occur easily, so it is always a good idea to plan baths at times when you will be uninterrupted and able to give the task your full attention.

Medications A person in your care may need to take a number of medications throughout the day. Get a pill scheduler (daily pillbox) with large deep boxes and lay out the proper dose of each medication for the day. Use an alarm clock to remind the patient (or you!) when the medicines should be taken. If the pills are large and difficult to swallow, ask your pharmacist about cutting tablets in half or mixing capsule contents with soft foods, such as pudding. Remember to keep all medications out of reach of children.

Finally, if you take care of the daily needs of others on a regular basis, it is important that you take care of yourself, too. If you are both physically and emotionally healthy, you will be better able to care for others. Think of the instructions given on an airplane regarding the oxygen masks. The instructions are to "first secure the mask over your own mouth and nose, and then secure one over your child or person needing help next to you." The same instructions apply when functioning as a caregiver-especially if you serve in multiple caregiving roles. Here are some general tips for staying physically and emotionally healthy:

• Eat nutritious meals and snacks.
• Exercise.
• Get plenty of rest and sleep.
• Practice meditation or relaxation techniques.
• Take a break from the caregiver role by asking for help or delegating responsibilities.
• Check in your community, with local churches, or on-line for caregiver support groups.

Resources

The National Family Caregivers Association can offer information to adults caring for loved ones.
National Family Caregivers Association, 10400 Connecticut Ave. #500, Kensington, MD 20895-3944; 800-896 3650; www.nfcacares.org.