San Diego Elder Answers
Expert advice for people caring for a loved one

Not all socks are created equal

What do a marathon runner and your aging parent have in common? Both could benefit from compression socks! By applying pressure to the legs, compression socks help the valves in the veins do their work—so blood is pushed back to the heart and doesn’t pool in the legs. The socks also help keep lymph fluid moving. Older adults with edema (swollen legs), varicose veins, or deep vein thrombosis find that compression socks ease discomfort and can even prevent problems. This is especially true if your relative spends a lot of time sitting.

Compression socks are safe for the vast majority of older adults and are an underutilized option. Consider them for your loved one before a long plane flight or car trip. You can even find fun ones online if you include “fashionable” or “crazy” in your search.

If you wonder about your relative using them regularly, consult with the doctor first. You want to know the right compression and size. Also, these socks are not recommended for those with diabetes and persons with certain heart or vein conditions. For long-term use, ask the doctor for a prescription. This will allow for graduated compression socks to be professionally fitted to your loved one’s calf and ankle dimensions.

Tips for compression socks

• Follow the fitter’s directions. Ask for tips on getting the socks on and off.
• Have your family member wear them an hour or two each day to start. Increase time gradually.
• Get a refit if your loved one gains or loses 10 lbs.
• Hand wash and hang to dry.
• Replace the socks when they lose their stretch.
• Check your relative’s skin for dryness, chafing, irritation, redness, or dents.

Ensure your family member wears a clean pair each day so socks don’t stick to the skin and become difficult to remove.

Dealing with anxiety

It’s only natural for family caregivers to worry. Understandably, we spend a lot of time thinking about “what’s next.”

But if you are in a pattern of persistent worry and are starting to feel the stress in your body too—perhaps headaches, loss of appetite, or trouble sleeping—you may be dealing with anxiety. You are not alone. An estimated 40 million Americans report problems with anxiety each year.

Does this sound familiar?

• Focusing on worst-case scenarios. Not seeing the things that are working well.
• Playing a worry over and over in your mind. This may distract you during the day and interfere with sleep at night.
• Thinking in black-and-white terms only. Your self-talk often includes “always” or “never.”
• Getting stuck on details. Forgetting to look at the big picture.

Try these challenges to negative thinking to help you arrive at a more balanced view:

• What are you saying to yourself? Write it down. Is this extreme or worst-case-scenario thinking?
• What do you know to be true? What is fact? What is just a thought or feeling?
• What is the worst that could happen? Is it a probability or just a possibility?
• What skills, resources, or qualities do you already possess? Give yourself realistic credit.
• What can you do now to make life easier (learn new skills, ask others for help)?

If anxiety is getting in the way of your sleep or peace of mind, talk with your doctor. And certainly, if you experience chest pains, a racing heart, and/or episodes of fast breathing, get checked out. Talking with a therapist can quickly get you back on a confident and even keel. And consider getting help with your caregiving.

Services at home: Medicare

Medicare is health insurance provided by the federal government. It covers adults 65 and older, as well as persons with disabilities. In terms of home care, Medicare pays for visits only by medically trained staff. In that light, there are two programs:

Home health care involves periodic home visits for a month or two. The focus is to bring the patient back to their previous level of health and ability. It is often initiated after a surgery or a multiday hospital stay. To be eligible, your loved one must have great difficulty leaving the house. Depending on your relative’s needs, services may include the following:

• A nurse to oversee progress
• A physical therapist to assist with rehab
• An occupational therapist to suggest strategies for living with new disabilities
• A speech therapist to address difficulties with speaking and/or swallowing
• A social worker to suggest community assistance programs

Hospice care is for people with an incurable illness. It involves weekly home visits over a period of six months. Sometimes more.

• A nurse to manage pain and difficult symptoms
• An aide to assist with bathing
• A social worker for emotional and other support
• A chaplain for talking through spiritual concerns
• A volunteer to periodically visit with your loved one, offering family members a few hours off

A hospice patient is not expected to regain their health. Hospice care supports the patient and the family. The goal is to allow the patient to live at home without pain or discomfort in the weeks or months that remain.

Both home health and hospice require a doctor’s order. If you think either one would be of benefit, ask the doctor for a referral. Most families wish they had received help earlier. Better to ask sooner than later.