Heat-related illnesses are a major concern to seniors and the elderly with 40% of all heat-related deaths in the U.S. being adults over the age of 65.  Seniors are less efficient at regulating their body temperatures for several reasons.  For example, people over 65 don’t sweat as much as younger adults, which helps the body to cool down and they also store fat differently, which affects their ability to regulate body temperature.  Seniors and the elderly also start to experience deterioration to the central nervous system, which makes the body less able to cope with changing body temperatures.

Caregivers need to be mindful of the signs an symptoms of heat-related illnesses among the elderly.  Early warning signs of heat exhaustion, which may precede actual heat strokes or other serious heat-related illness, include excessive sweating, fatigue, muscle cramps, prolonged headaches and dizziness.  As heat exhaustion progresses, symptoms can sometimes progress to nausea, vomiting or fainting.  A heat stroke, in which the internal body temperature rises father than it can be naturally lowered, can strike within 10-15 minute of these symptoms.  Actual heat stroke symptoms include extremely high body temperatures, confusion, seizure and coma.

If you are a caregiver for seniors or the elderly and you see your patient experiencing these symptoms, do not hesitate to call 911 immediately.  Then, get them in to an air conditioned environment immediately, have them lie down in a cool place or put a fan on them directly.  Providing cool liquids or even a cool bath will also help to reduce internal body.

Here are some tips for keeping seniors and the elderly safe in hot weather:

Drink Liquids – Dehydration is the principal cause for most heat-related illnesses.  Have your patients drink plenty of water or juice throughout the day, even if they are not thirsty.  Remember to ensure that they avoid alcoholic or caffeinated drinks because they can actually contribute to dehydration.

Wear Appropriate Clothes – Have your patients wear light-colored, lightweight, loose-fitting clothes and a wide-brimmed hat.

Stay Indoors During Peak Hours – Keep your patients indoors during the peak times of the day for extreme heat.  If they have to be outdoors, try to make it before 10 in the morning or after 6 in the evening.  The temperature is much higher in those hours in between.

Reduce Exertion – Ensure that your senior or elderly patients avoid exercise or any type of strenuous activity, particularly outdoors, when outside temperatures are high.

Watch the Heat Index – High humidity, caused by a lot of moisture in the air, impairs the body’s ability to cool itself through sweating.  The heat index take into consideration temperature and humidity to determine how hot it actually feels.  Caregivers should pay attention to their local heat index, which can be found on weather websites and during the weather forecast on local television or radio station reports.  Seniors and the elderly should be kept indoors during high heat index days.

Keep the A/C Working – Caregivers should be mindful of the condition of a senior or elderly patient’s air conditioning unit to ensure that it is fully functioning during extreme heat.  If the A/C system does go down, which is not uncommon when it is working overtime in 90+ degree weather, caregivers need to seek other alternatives to get seniors and elderly patients into air-conditioned environments.  The mall, libraries and movie theaters are all good options.

For more information about caregiving in Maryland, contact United Medical Care at 1-844-687-7378, or admin@unitedmedicalcare.org, and let us bring health care to your home.

Another solution that families are seeking for their aging-in-place seniors is the help of home caregivers. Hiring a home care agency to assist seniors with daily living challenges can be even more effective than home improvements intended to help seniors.  Caregivers can react to real-time issues, target concerns proactively before they become problems and they also provide value above and beyond what static home renovations offer.  A  home care agency can provide assistance with daily living activities including, but not limited to, meal preparation, help with dressing, personal grooming, toileting, medication reminders, transportation and light housekeeping.  If the caregivers are from a skilled nursing agency, they may also be able to perform therapeutic or some complex health-care tasks as well as administer medication.

Having a caregiver provide home care services to your loved one can significantly augment the capabilities of a working family trying to support a senior who is aging in place.  Caregivers also offer invaluable companionship to seniors which is sometimes worth the investment alone.  They take pride in their work because they feel honored to care for the generation that once cared for them.  A home care provider is an excellent choice for seniors aging in place because they become a personal consultant to the family and a real advocate for the senior – which is more important than a one-time home safety improvement. Caregivers recognize health patterns that the senior, or their family members, may not readily see and they’re able to point out areas, personally and in the home, where care can be improved.  With this kind of support, seniors can stay in their own homes and retain their independence rather than moving to a facility and delegating control of their care to someone else.

Depending on the state, programs such as Medicare may cover non-medical home care services and many long-term care insurance policies may cover non-medical in-home care as well.  The best way to find an in-home caregiver is through referrals from health care professionals or from others who have used in-home caregiver services.  We strongly recommend that you hire a caregiver through a certified agency rather than hiring a freelancer directly who may not have all of the necessary credentials to provide care properly.  In addition, many healthcare professionals will recommend using an agency to hire a caregiver.

The home care agency will handle all required caregiver training and it also serves as the caregiver’s employer, covering payroll taxes, Worker’s Compensation, and Liability insurance.  In order to hire a reputable home care agency, you should be sure to ask questions about the agency’s attrition rate, how backup assistance is handled if a regular caregiver is ill or needs a break, training practices, background checks and required certifications.  Highly credible home care agencies like United Medical Care LLC will be able to answer these questions to your satisfaction and will also be able to walk you through the process of applying for home care benefits.

Contact us at 1-844-687-7378, or admin@unitedmedicalcare.org, for more information and let us bring health care to your home.

We think the following broad stages best reflect the logical progression:

1. High-Early Stage of Dementia

Cellular death in the area of the brain responsible for executive cognitive function, which is the last to develop and the first to decline, presents as the earliest stage of dementia.  This stage is often seen in conjunction with regular activities of daily living (ADLs), which include driving, managing medications, managing finances, and cooking.  At this stage, seniors may need a caregiver at home to provide daily support for solving problems or adjusting to routine changes.

2. Low-Early Stage of Dementia

A telltale sign that dementia is progressing manifests in the degradation of ADLs pertinent to personal care such as dressing or showering.  At this stage, seniors may need 24-hour supervision because judgement skills may be significantly impaired, increasing the possibility of accidents and injury.  Compromised cognitive ability may also make seniors with low-early stage dementia susceptible to predatory behavior by people trying to take advantage of the situation.  This stage may be hard to identify because some critical abilities may remain and seniors could still be able to carry out sequenced tasks for themselves.  It is crucial at this stage for caregivers to leverage seniors’ long-term memory to increase opportunities for independence and to limit anxiety.

3. Middle Stage of Dementia

Although there will be various levels of cognitive loss during this time, the middle stage brings major memory deficiencies.  Seniors may no longer be goal-oriented and will likely be unable to follow sequential tasks.  It is common for seniors to forget their address or telephone numbers at this stage. Caregivers will need to simplify tasks and also look for ways to jog memories based on familiar aspects of a routine process.  It is important to continue to encourage seniors to be participatory in meaningful activities which can be simplified at this stage.

4. Late Stage of Dementia

The late stage of dementia is one of the most challenging for both the patient and caregivers.  At this stage, seniors start to forget names of close family members and have little memory of recent events.  They may only be able to recall limited details of earlier life.  Incontinence is a common problem in this stage.  The ability to speak begins to decline and personality changes, such as delusions, compulsions or anxiety and agitation are likely to occur.  Fine motor coordination becomes noticeably compromised at this stage and additional health issues may contribute to greater functional loss.  Caregivers should attempt to get seniors to continue to participate in two key ADLs; self-feeding and toileting.  

5. End Stage of Dementia

The brain has significantly atrophied at the final stage of dementia and seniors may be mute and confined to their beds.  People in this stage have essentially no ability to speak or communicate and will usually require assistance with most activities.  They often lose psychomotor skills completely, such as the ability to walk.  Senior will still have their five senses intact though and can respond and engage with anyone who stimulates them.  Even at this stage, seniors are capable of some level of interaction provided that activities are reduced to the basic sensory level.  

Dealing with the harsh realities of dementia and its impact on loved ones can be incredibly stressful for a family. Hiring a professional home care agency, like United Medical Care LLC, can greatly reduce that stress because we offer a true partnership with families and use collective economy of effort to provide the best possible care for dementia patients.

Contact us at 1-844-687-7378, or admin@unitedmedicalcare.org, for more information and let us bring health care to your home.

The Sandwich Generation of caregivers are between 35 and 55 and find themselves in a difficult balancing act trying to provide care for two different age groups, each with their own set of unique challenges. Imagine the strain of caring for kids, who have an abundance of energy, educational needs and their own health care issues along with caring for an elder, who may have little energy or may even be incapacitated, but also has social needs and a variety of complex health care requirements.  Families that find themselves in this scenario have to make sacrifices that are different from other caregivers.  Husbands and wives often have to draw straws to decide which of them is going to miss their child’s little league game in order to get Grandmother to her next doctor’s appointment.

This daunting task of caring for children and elders makes members of the Sandwich Generation more likely to become isolated than caregivers who do not have children at home.  This special category of caregivers often feel guilty or depressed for not having enough time to do all of the things they want to accomplish.  For example, many are still trying to make strides in their career and want to accomplish their own personal goals but, literally, feel caught in the middle of their caregiver responsibilities.

These caregivers are especially susceptible to burnout so it is important that they take breaks and make time for themselves.  Caregivers needs to take mental breaks, eat well and exercise so that they can continue to be effective for their loved ones.  Individuals in the Sandwich Generation who are experiencing high levels of stress based on their caregiving responsibilities should seek out counseling, join support groups or request help from other caregivers who can provide respite care support.  Hiring a skilled nursing agency like United Medical Care LLC can help to offset the time requirements, physical and mental drain of caregiving for your loved ones.

Before exhaustion, depression or isolation starts to impact families, they should seriously consider professional caregiving services.  Some people feel that they shouldn’t rely on outsiders to provide care to their family members but that mentality can contribute to a multitude of problems.  A carefully selected professional caregiver can give those who are feeling pressure from both sides, kids and parents, a great deal of relief.  Home care agencies can offer affordable respite care options to help provide the necessary balance that those in the Sandwich Generation so desperately need.

Contact us at 1-844-687-7378, or admin@unitedmedicalcare.org, for more information and let us bring health care to your home.

1.  Judgement Skills.

Caregivers have to know when a patient is pushing it too hard or, on the opposite, when they are not pushing hard enough to be a part of their own care.  Is the patient really too tired to take a bath today or are they just refusing to participate out of protest?  This takes careful observation and, sometimes, very good intuition.  Knowing the difference between when a patient is just not feeling well that day and when something is really off kilter from their usual level of effort could help to save a life.  And knowing when to share that information with family members or other stakeholders is absolutely critical.  

2. Problem Solving.  

The best caregivers know when something needs to be done … and they do it!  Caregivers are often balancing support for many people; their patients, themselves and their own families.  This kind of stress can make it easy to slack off when an issue doesn’t affect them directly, however the good caregivers know that they can’t become weary and have to address things as they arise when it comes to their patients.  It’s not enough to know that something needs to be done – so they demonstrate initiative to take action!  They will have tenacity and resilience to solve problems as necessary to help their patients.

3. Enthusiasm.

It’s true of any profession – you have to love what you do – but it’s especially applicable to caregivers.  Great caregivers uplift their patients and are usually the best part of their day.  Elders and disabled face unique challenges ranging from the isolation that can be felt from losing personal freedom to the strife associated with pain management and depression related to financial matters.  Outstanding caregivers bring light into these dark situations by reminding their patients that they are still part of a wonderful world and making them feel like important parts of it.  They’re able to do this because they genuinely love their work.

4. Big Picture Thinking.

When you’re taking care of a patient you become a part of their personal ecosystem.  When things don’t add up, caregivers have to take a holistic view of that world to look past the obvious and determine what’s going on behind the scenes.  There are many factors that have to be considered when it comes to elder care and caring for the disabled.  Interactions associated with medicines, dietary restrictions, emotional and cognitive capabilities that may be diminishing and the possibilities of undiagnosed issues that may be having a silent impact all have to be thought about.  Exceptional caregivers are able to view their patient’s ecosystem from a holistic viewpoint to form a better understanding of their needs.

5. Great Communication.

Caregiving relies on excellent communication because of the importance of connecting with patients and their families.  Given that some patients may not be able to communicate verbally, this makes listening and non-verbal communication just as important for caregivers.  Being able to convey important information in a way that’s clear, concise, and creates an atmosphere of trust for everyone involved is an absolute necessity.  Caregivers must also be able to communicate effectively with their employers and other key stakeholders such as medical professionals or social workers.  Misunderstandings, overlooked issues, and even serious health and safety issues can be avoided with clear communication from the caregiver community.

Caregivers who demonstrate these five traits are the best candidates to support elder care patients and disabled patients.   This combination of judgment skills, problem solving, enthusiasm, big picture thinking and great communication makes for a dedicated and professional caregiver who is truly vested in the success of their patient’s care.  Look for these traits when hiring an in-home caregiver or let your home care agency know that these are the things you want in the caregivers they assign to your loved one.

Proper foot care for your senior, elderly or disabled loved one is vitally important to their overall health and well being.  Foot problems can affect a senior, elderly or disabled person’s mobility, which also correlates to their level of independence and limits their ability to engage in exercise.  Maintaining healthy feet can also improve balance and reduce the risk of falls in the elderly.  It is also beneficial to monitor foot health in order to spot warning signs for different types of health problems such as diabetes, arthritis, poor blood circulation and nerve damage.  These can all be detected by their  effect on feet and toenails and can serve as indicators for the need for medical attention.

According to some statistics, one in three people over the age of 65 cannot cut their own toenails which means that millions of seniors are potentially at risk from a variety of problems.  Here are some of the more common:

Ingrown Toenails.  When the toenail curves downward and grows into the skin, usually at the sides of the nail, this can cause swelling and pain.  And if the skin is broken infection can set in.  These problems are much more likely to be serious if the person has circulatory problems or diabetes.

Fungal Infections.  Thickening or discoloration of the nail, usually yellow or even green, which can cause the nail to fragment or fall off.  Walking can become quite difficult because of the pain.

Thickened Toenails.  Known as onychogryphosis, this condition is caused by a heavy object hitting the nail or through gradual damage over time.  Walking with thickened toenails can be very challenging.

Overgrown Toenails.   When nails grow beyond the end of the toes and start digging into the skin.  Obviously this also affects walking.

There are a variety of ways for seniors, elderly and the disabled to keep their feet healthy which,  in turn, can vastly improve their quality of life.

Check Feet Regularly.  At least twice a week, make sure feet are checked to prevent problems becoming established.  Look for redness, bruises, sores, swelling, cuts, blisters and ingrown or infected toenails. A long-handled mirror can help people check for themselves if bending poses difficulties.

Wash Feet Daily.  Regular washing helps to avoid infections and soreness. When drying feet, be sure to pat them rather than rub and be sure to dry well between the toes. Talcum powder can be helpful for sweaty feet.

Use Lotions.  Creams and moisturisers can help to keep feet healthy, especially if they damaged due to cracking and calluses  When using theses products ensure they are rubbed in and that extra amounts do not remain.

Wear Proper Shoes.   Many foot problems are caused by ill-fitting shoes.  There are various brands designed with the elderly and disabled in mind.  Socks are just as important.  It’s best to avoid socks with elasti tops as these can be irritating and restrict circulation.  White tube socks will also make it easier for caregivers to spot blood or discharges.

One of the best ways for older and disabled people to maintain proper foot care is to hire a home care agency.  Caregivers can help to remind your loved ones about the importance of, and need for,  good foot care.  They can tend to a person’s podiatry needs and keep their feet well-maintained in order to avoid a host of problems for your senior, elderly or disabled loved one.

It is a fact that home care agencies in Maryland are growing and this presents a wide variety of choices for families and clients in need of in-home caregivers in The Old Line State.  Being mobile is important to a client’s physical, mental and social well-being and, with so many alternatives for care, it is important for families and clients to look for agencies that have proper training programs for safe ambulation assistance to avoid falls.  Bone loss due to osteoporosis is a major cause of frailty in elderly people as skeletal bones are at risk with aging. Ambulation assistance means helping elderly or disabled people with a limited ability to sit up independently from a reclining or sitting position, or to walk or transfer to a wheelchair.  Without proper ambulation techniques, caregivers can actually create additional risks for falls among seniors and the elderly.

The first thing for caregivers to know is the weakest side of the client, as this is the side which caregivers should work from.  If the client requires a gait belt, place it around the client before lifting them up.  A gait belt is a useful device which is used to transfer people from one position or thing to another or while ambulating people with balance problems.  Moving a client from a standing position to a wheelchair would be a good use of a gait belt.  In order to ensure that a gait belt is always used with every transfer, a good tip is to keep the device in a specific place in every room.

When helping a client from a lying position, do not grab them by the wrist or hands to pull them up or move them because wrists and hands are susceptible to breakage, even from a slight amount of pressure.   Proper technique should include putting one arm under the client at the back and one arm under the legs at the knees.  Do not twist the client’s body while moving them and ensure that the client ends up sitting on the edge of the bed with their knee and calves flush with the side of the mattress.

When helping a client from a sitting or reclining position, ensure that pillows are placed on the bed where the head will rest and when transferring the client back to the bed, the caregiver must assure that the client’s knees are even with the edge of the bed.  Then, supporting the back, lift the client under the knee calves by rotating the body on the buttocks and gently laying the client down.

Caregivers should understand how balance works.  Balance is achieved by maintaining a person’s center of mass within their limits of stability and/or base of support and it requires both sensory input and motor output.  Also, basic body mechanic principles are very important.  For example, adjusting the height of the bed as needed, using a wide base of support (with legs spread apart), maintaining the natural curves of the back (bending at the knees and hips), and getting your center of mass close to the client’s center of mass are all tips which caregivers should employ.

Movement equates to freedom and, in many ways, it can define a person’s independence.  When movement is compromised in senior and elder care clients, it can  trigger depression, a large loss of motivation or even circulation problems.  Caregivers can greatly improve the quality of life for their clients through proper ambulation techniques.  The information presented here is not intended to replace any specific ambulation training and should not be used as a substitute for proper ambulation training.  United Medical Care LLC strongly encourages caregivers to receive ambulation and fall prevention training from a reputable and certified program.

Photo courtesy of Witthaya Phonsawat at FreeDigitalPhotos.net

Caregiving is one of the most challenging roles that a person can perform because it requires a significant amount of physical, mental and emotional energy in addition to a considerable investment of time.  The stress can be magnified when the caregiver is a family member.  Respite care is a period of rest or relief and it is vitally important because it gives family caregivers the chance to care for themselves.  Family caregivers need an opportunity to take a break with respite care and this is often something that can be provided by a home care agency.  Even a respite of a few hours a week can allow family caregivers to recharge their batteries, while resting assured that their loved ones are still being cared for properly.

Without a plan for respite care, family caregivers can experience burnout which, in turn, can result in illness and resentment.  When caregivers experience burnout they can become withdrawn, anxious, irritable, depressed, forgetful and inattentive, which are not healthy for those who are in need of care.  Respite care helps family caregivers to feel more relaxed and fulfilled, which translates to better care for their loved ones.  There are many types of respite care but it usually involves enlisting support from a home health care agency which provides professional caregiving services during a period of time when the family caregiver is away.  An alternative to home care agencies is volunteer respite providers, such as church or community groups, however the level of training required will depend on the level of care necessary.

Respite care isn’t just helpful for the caregiver; it can also be beneficial to the senior, elderly or disabled loved one. Those receiving care can begin to feel guilty seeing the effects that their care takes on their caregivers so respite care also allows the loved one to receive some relief.   The first step in seeking respite care is for family caregivers to first acknowledge that their caregiver role is separate from their ordinary role in the household as a family member.  For example, a survey by the National Family Caregivers Association showed that spousal caregivers often refuse to accept that their caregiver role is separate from their role as a spouse.  Accepting this fact will allow family caregivers to feel comfortable with seeking out respite care so that they can take care of themselves.

Family caregivers may not be as effective in their vital roles without respite care so it is important that they get the breaks that they need.  Aside from giving caregivers the opportunity to have some social interaction or to take care of their own familial priorities, respite care can also provide much-needed time and space for reflection.  When caregivers have an opportunity to step away and think about the situation they can come back with fresh perspectives on how to make adjustments in their support to improve the experience for their loved one.  Being a family caregiver can be quite rewarding but it takes a toll on a person so respite care should be considered as a definite necessity and not a luxury.

One of the most disturbing aspects of elder care abuse is that it almost always involves a trusted relationship with the elderly person.  Overwhelmed family caregivers can sometimes reach a breaking point and become neglectful in their duties or, even worse, begin preying on the very people they have pledged to support.  In order to report elder care abuse, families first need to be able to identify the  various types and warning signs.

Emotional abuse

This occurs when people treat elderly persons in ways that cause emotional pain or distress.

Sexual abuse

Sexual abuse against elderly persons is contact without the elder’s consent.  This can involve physical sex acts and also showing them pornographic material, forcing them to watch sex acts, or forcing the elder to undress.

Neglect or abandonment by caregivers

Elder neglect, which is the failure to fulfill a caretaking obligation, represents more than 50% of all reported cases of elder abuse.  Both intentional and unintentional neglect can be based on factors such as ignorance or denial that a patient requires a particular level of care.

Financial exploitation

Unauthorized use of an elder’s funds or property, resulting from misuse of their checking or credit card accounts, stealing cash or goods, forging an elder’s signature or stealing their identity.

Healthcare fraud and abuse

This is considered unethical treatment by doctors, nurses, hospital personnel, and other professional care providers such as charging for healthcare services but not providing it, overcharging for services, over-medicating or under-medicating an elder, getting kickbacks for referrals and Medicaid fraud.

There are several ways to spot these different types of elder abuse.  For example, tension or arguments between the elderly person and their caregiver or changes in the elder’s personality or behavior.  Unexplained bruises, welts, especially if they occur symmetrically on two sides of the body, broken bones, sprains, medication overdoses, broken glasses, signs of restraint such as marks on wrists and a caregiver’s refusal to allow family members to see an elder alone are all telltale signs of abuse.

There are several things you can do as a concerned friend or family member to help those who may be experiencing elder care abuse.  Monitor the elder’s medications and ensure that the amount corresponds to the date of the prescription.  Watch out for financial abuse by asking elders if you may see their bank accounts and credit card statements to review them for any unauthorized transactions.  Try to call or visit elders as often as possible so that they know they have a trusted person they can confide in.  Also, it’s a good idea to make offers to stay with elders so that caregivers can have a break if at all possible.  And, of course, the most important thing you can do is to report any suspected abuse to the proper authorities.

Photo courtesy of Praisaeng at FreeDigitalPhotos.net

Caregivers providing senior care often have problems helping older adults with bathing yet it is one of the most important, and prevalent, aspects of caring for the aging in place population. Taking a bath is one of the most personal things that any of us can do and our elders may feel like their pride is taking a backseat to their health when they need bathing assistance. When elderly patients resist bathing assistance they can often experience dangerous slips and falls in the tub, resulting in fractured and broken bones or worse. And if they refuse assistance altogether, and do not shower or bathe, the health implications can be significant.

There are a variety of reasons that the elderly may resist receiving bathing assistance. For example, they may be ashamed for someone to see them naked or their eyesight may impair their ability to judge the depth of the water and they may fear drowning.  These are common issues for caregivers providing home health care to the elderly.

Here are five tips that caregivers can use when trying to help bathe an older patient:

1. Offer the patient as much privacy as possible and ensure that there is adequate lighting and a safe environment for the bath. Shower benches, grab bars, non-skid surfaces, and hand-held shower heads that elders can use themselves may help elderly patients feel empowered during the process. Allow them to do some of the work, if they are physically able, so that they can maintain some independence.

2. Determine the best time of day for the patient to receive bathing assistance. Sometimes navigating around the patient’s preferences and establishing a mutually agreed upon time frame for baths can make the patient feel better about receiving assistance because they’re being included in the decision-making process.

3. Establish a separate time for washing the patient’s hair so that the patient does not become overwhelmed. If the bathing session takes too long the patient may not want to continue receiving assistance because of the amount of energy and focus it takes on their part. Having a separate, dedicated, time for hair-washing can help to alleviate that problem and also create an activity that the patient might actually enjoy.

4. Negotiate the frequency for full baths or showers with the patient. Typically, three times a week for a full bath or shower is sufficient, with sponge-bathing in the interim. Setting the number of full baths a week upfront can help elderly patients feel more comfortable with receiving assistance because they can mentally prepare themselves. And it also allows them to have some control over their own home care.

5. Ask the patient, before beginning the bathing process, about their specific concerns in order to remedy the problems beforehand. For example, if the patient fears falling, additional grip bars can be installed or if they fear drowning because of poor eyesight, a mat made of a bright color can be put on the bottom of the tub to help the patient gauge the water level. It is always better to find out the patient’s concerns before starting the bath rather than midway through.

Caregivers have to be flexible enough to deal with the patient’s unique concerns. Providing bathing assistance during in-home senior care can be daunting but the challenges can be overcome with some strategic planning. By respecting the patient’s need for independence and appreciating their specific concerns, caregivers can work through the problems associated with bathing assistance for the elderly and help the aging in place to maintain a proper level of hygiene.