Supporting Older Adults with Activities for Daily Living

ADL Support: Supporting Older Adults with Activities for Daily Living

A combination of skill and compassion means more independence and greater comfort for the older adults you care for

You have scores of skills and dozens of techniques at your disposal to help the older adults you care for manage the activities of daily living (ADL). But, it’s the qualified caregiver who also has the heart and compassion that can make the most positive impact.

“That’s what I always tell people,” says Russell, a Registered Nurse and caregiver educator for HomeCare of the Rockies. “We are here to be of service to older adults,” Russell says. “Each client is unique and each will have unique needs. You have the skills and techniques to care for them, but to be in full service, you also need to have that human aspect, heart, and compassion. When you bring all of this you can care for the older adult and help preserve their dignity and sense of self.”

Russell helped develop the curriculum and now teaches the Skills for the Professional Caregiver session of the HomeCare 100.

Led by HomeCare of the Rockies, the HomeCare 100 provides caregivers both comprehensive classroom education and practical, lab-based training. The curriculum covers a range of topics including how to assist with the activities of daily living, functional mobility strategies, management of oxygen devices, as well as, safety and fall prevention approaches, and dementia-care training. Caregivers also receive pay increases for each level of training they complete and those who complete the 100 hours are awarded special certification.

The HomeCare 100 is part of the three-tiered Caregiver Call to Serve program led by Sandi McCann, president of HomeCare of the Rockies, providers of in-home professional caregivers to seniors living in Boulder, Longmont, Louisville, Lafayette, Broomfield, Loveland, and surrounding areas.

“Our caregivers spend much of their day assisting seniors with activities of daily living like safe transfers, hygiene care, and other care support, so it’s essential that they have the knowledge and practical, hands-on training to know how to help the seniors with these tasks,” says Sandi McCann.

Providing ADL Support, Preserving Independence

But keeping up with the daily tasks does become more difficult as we age. Many seniors may no longer have the interest or the energy to handle household chores, prepare meals, or even keep up with regular self-care, showering, and grooming.

Others have limited functional mobility as a result of chronic illness, injury, stroke, and other conditions that make it difficult to complete these tasks on their own.

This lack of function is not only frustrating for older adults who have taken care of their own needs their entire lives but also a major reason why many need the support of a professional caregiver or assisted living community.

Yet knowledgeable, professional caregivers can help seniors adapt and manage activities of daily living in a way that also preserves their dignity and sense of self.

“We need to remember, every step of the way, that these older adults were fully functioning, independent people for most of their lives,” McCann says. “That spirit and desire doesn’t change even as physical limitations emerge. Everyone wants to live independently, to feel as though they are in charge of their own lives. A qualified professional caregiver can respect that, and help them live it as much as possible.”

ADL Support for Seniors

No matter how much the older adult is capable of doing, there are a few tips and strategies that can make activities of daily living easier to manage for both you and the senior you serve.

Keep to a routine. A routine can benefit seniors and caregivers alike, so find out what the older adult prefers and create a plan around it. Perhaps, she likes to have a cup of coffee in her bathrobe, before getting dressed for the day. Maybe she likes to wash and dress first thing. When you know what is most comfortable for the client you can create a routine that also includes activities, meals, medication schedules, and other activities of daily living.

Adhering to a “toileting schedule” can be another significant help for older adults with incontinence, Russell says. Setting regular times to use the bathroom in the morning and throughout the day can help reduce episodes of incontinence, train the bladder, and preserve the senior’s comfort and dignity.

Having these personal care tasks built into the regular routine helps normalize them and can ease embarrassment for the senior, Russell says.

Tip: Use the time in the bathroom to complete other self-care tasks. Assist with handwashing after toileting and then help with grooming, oral hygiene, and washing.

Set out supplies ahead of time. Before beginning toileting, hygiene care, or any activity, lay out all the items you’ll need to support the senior with the task. The older adult may even be able to handle all or part of the activity on his own, if you have the supplies ready. For example, can he brush his teeth if you put on the paste and hand him the toothbrush? By preparing ahead of time, you and your client will have easy access to all you need to finish the task successfully.

Take it slow and be patient. Sometimes an older adult can complete the activity, but may need more time to do it. If the morning routine takes awhile, Russell says, that’s just fine. It is most important to allow the senior to do what they can do independently rather than rushing the process.

Help with bathing two to three times a week. Aging changes our skin making it less oily, and more fragile so take care as you help bathe the older adult you are caring for. Limit full showers and baths to a few times a week to prevent dryness and other skin complications. Even partial baths can help promote good hygiene and release dead skin cells that can all harbor bacteria and increase the risk of skin breakdown or infections.

Tip: Be sure to evaluate the bathroom for safety. Would a shower bench help with bathing? Could a raised toilet seat make it safer? Are grab bars installed in convenient areas? Talk to your care manager (or family contact if you are a private caregiver) if you think some special equipment or tools could help.

Allow older adults to choose their own outfit. One of the greatest forms of independence and self-expression is articulated through the clothing we wear and older adults, like everyone else, have their clothing preferences. Encourage them to pick their own outfit.

If the older adult is living with dementia, or has a difficult time choosing, limit the choices to a couple of items. And, suggest loose clothing, shirts with large buttons and pull on pants that can make dressing easier.

As you help the older adult to dress, go slow, supporting the joints and injured or weak limbs, as needed. Also, make sure they wear good-fitting socks, and shoes with good, non-skid soles for safety.

Act with self-awareness. Toileting, bathing and other forms of personal hygiene care can sometimes be uncomfortable and embarrassing for both the client and the caregiver, but your professionalism and compassion can go a long way toward making those moments more routine and less difficult for all involved.

When assisting with incontinence care, toileting, personal hygiene, or cleaning up soiled clothing or linens, stay calm and compassionate. Monitor your facial expressions, body language, and tone, Russell says. Stay neutral and reassuring.

If you appear uncomfortable or upset, the older adult you are caring for during that vulnerable time will pick up on those feelings and may feel ashamed or embarrassed. Also, avoid chastising, or “parenting” the older adult.

Calm, quiet professionalism is the best way to preserve dignity, encourage independence and provide the care and compassion every older adult deserves.

Ready to learn more techniques to help the older adults you care for manage the activities of daily living and maintain greater independence? Call now, 720-204-6083 and find out how you can become part of the dynamic HomeCare of the Rockies care team and enroll in the HomeCare 100 Training Curriculum where you earn more as you learn more.

Are You Prepared to Help Care for Clients with Respiratory Conditions?

Many of the older adults you care for will be living with chronic respiratory conditions that require care and support. Knowing how to help them use supplemental oxygen, nebulizers, and Continuous Positive Airway Pressure Machines, or CPAPs, can make a significant difference in the care and comfort of the older adult.

Below are some basic explanations of the machines used to help patients with respiratory illness. Through the HomeCare 100 Training Program, HomeCare of the Rockies caregivers learn how to use each device during a hands-on, lab training.

Supplemental Oxygen

Supplemental oxygen is used to increase oxygen levels in the blood. It’s often administered via a portable tank and a tube that the older adult wears in her nose. The portable tank connects to a valve on top of the larger tank and is filled by simply opening the valve. Concentrators plug into the wall and “concentrate” room air to provide the proper level for the client (these are heavy and not easily moved, so the client will likely have a small gaseous tank for portable use). A valve on the tank shows flow and levels of oxygen in the tank. The valve is opened with a special wrench.


This machine turns liquid medicine into a mist that can be inhaled into the lungs during slow, deep breaths through a mouthpiece. Nebulizer sessions often take 10 to 15 minutes and a caregiver can help by emptying the premeasured vials of medication into the nebulizer medicine cup, connecting the hose to the mouthpiece, making sure that the senior puts their lips tightly around the mouthpiece so that the medicine can be inhaled. Caregivers should also be prepared to turn off the machine when done, wash the cup and mouthpiece, and allow to air dry in a clean safe place until the next treatment.

Continuous Positive Airway Pressure Machines (CPAP)

A CPAP Machine helps clients with obstructive sleep apnea. With sleep apnea, throat muscles relaxed during sleep can sometimes block airways and interrupt breathing. A CPAP machine uses continuous positive pressure to help keep those airways open.

The older adult you care for may need your assistance to set up the machine and place the mask on his face before bed. The mask should fit snugly, without air leaks. If you have concerns about the fit, talk to your care manager. Adjustments are usually made by respiratory therapists.

After use, wipe down the mask with damp towel, mild soap, and warm water. Then rinse and allow to air dry. Empty any leftover water after each use and let the humidifier container air dry. Refill the humidifier with clean, distilled water prior to use.

For seniors living with respiratory disease, a qualified caregiver can help ease the challenges making it easier for them to receive the care they need to breathe easier.

If you aren’t familiar with these machines or how to use them call your care manager for direction and enroll in caregiver skills training which will help you help your client.

You can also learn more about these devices and respiratory care through the HomeCare 100 Curriculum Training led by HomeCare of the Rockies. Call now to enroll and find out how you can earn more while you learn more 720-204-6083.

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