On the whole when working with the aged life tends to S L O W down. These folk take longer to get from A to B, occasionally requiring a “sit down break” along the way. Their muscles have less power and their limbs are more fragile and one of the worst catastrophes that can befall any of them is a fall.

Falling is the number one fear for the majority of the aged. Lumps, bumps, skin tears and haematoma are bad but fractures are far worse. A hip fracture will probably lead to long hospitalisation and recuperation and is sometimes the end of what is otherwise a happy, mobile and satisfying lifestyle.

Aged bones take longer to heal and some folk may have osteoporosis as well just to complicate matters. Often the aged have to endure arthritis particularly prevalent and common, Osteoarthritis.

They usually take copious amounts of pain relieving medicine such as paracetamol tablets and/or analgesic rubbing creams. Some who require a stronger pain relief use a group of medicines called NSAIDS (anti-inflammatory drugs) to help reduce swelling and stiffness in their joints, although some people are not able to take anti-inflammatories. If all else fails to relieve pain, a stronger analgesic such as an opioid can be used. Of course there are always side effects and risks to any drug being used and for a complete understanding of this you or your client can read the Consumer Medicine Information (CMI) leaflet readily available from a doctor or a chemist. The Australian Rheumatology Association and Arthritis NSW or Arthritis Australia also publish medicine information sheets.

Your client may also visit a physiotherapist who can show them exercises to strengthen and stretch their muscles in their joints to help improve their function. They will show your client various pain relief techniques as well such as the use of heat packs, walkers, walking sticks and massage.

An OT (Occupational Therapist) may also be able to help them. An OT can provide advice on how they can do things in their home in order to reduce their pain, for example by using handrails in pertinent places or by using splints for joint protection.

There are many things that can be done for a client who lives with pain everyday, but the first step is a positive attitude. If your client really believes that their condition can improve it can relieve or actually reduce the symptoms. The client who lives with pain needs practical as well as emotional support and you as a caring carer is pivotal in providing both, particularly emotional support.

Be patient when dealing with those in chronic pain. Some clients can be ill tempered or temperamental on occasion. They require a lot of empathy, thoughtfulness and respect, their physical comfort being of utmost importance. Some clients, many of whom are in their nineties, do not experience chronic pain although they still may require the use of a walking stick or rollator to keep them steady when moving around.

A rollator is a must for anyone who is tottery on his or her legs. They not only offer support and balance but some have a little seat to have a rest on when needed with a removable basket underneath it to carry a small amount of goodies such as spectacles, books and handbag.

When walking with someone with a rollator be mindful of steps, uneven surfaces, gutters and steep inclines and declines and if your client uses a walking stick, be mindful of not losing it or leaving it behind anywhere, if it is not used terribly often other than outside their home.

I used to know a client who used their walking stick quite infrequently, however if they went anywhere by public transport carried it with them and used it as a “weapon of mass destruction” in unashamed fashion if someone got in their way. I can assure you a good “belt” around the ankles will move anything quicker than speedy Gonzales in a lap dash!

As you may have noted already, not all elderly people age gracefully! If you think about it, if you were old, sick and in pain a lot of the time, no one came calling and you were unable to get out and about like you used to, you too would probably feel lonely and abandoned, maybe useless and probably quite frustrated.

 That is why socialization is so important for your client. If your client is unable to get out into the community but can have contact with at least one or two people a week, they can feel a lot less lonely and abandoned.

It is also good for the isolated aged in our communities to enjoy the benefits that socializing outside the home can bring. Events like enjoying an accompanied trip to the local library once a week, shopping, going to bingo, church, scrabble, playing bridge or participating in group craftwork.

Even joining an art class, if the eyesight permits, can help to bring more meaning to your client’s life as well as keeping the brain cells firing.

In some local communities, going along to an adult day care centre can be entertainment for some. Usually there is a small community bus that can pick clients up from their home and drop them back later in the afternoon if someone is unable to take them. Likewise community buses can take the aged shopping and drop them home. Day Care centres can provide lunch and morning and afternoon tea along with various activities provided at the centre. Occasionally the clients are taken out for a day outing in the bus provided.

There are clubs that can provide companionship and fun such as Probis or Lions clubs that provide group outings and/or help the community in some way. All sorts of opportunities are available to the aged for socialization. It just takes a bit of thought, planning and a positive attitude.

 Even clients with Parkinson’s disease, disability and/or dementia can be taken on an outing. In fact in April 2008 the NSW Government announced that it plans to introduce a free “companion card” for carers enabling those in NSW with severe or profound disability to be able to take their carer with them on public transport and to events for a single ticket price. This card, according to the Hon. Kristina Keneally, the NSW Minister for Disability Services, “recognizes that a carer is indispensable to a person with profound or severe disability, giving them equal access to services and facilities like everyone else…”

From the book "Strong Hands, Gentle Heart" by Toni Cary
Available through Aspire publishing