Providing Care at Home

If your loved one has a serious or life-limiting illness, the care tips below will help you care for them at home.

Families of Samaritan’s Hospice Care patients should call us at (856) 596-1600 for advice, any time or day or night if:

pain or other symptoms are getting worse
a change worries you, or
you need medication changes or refills before your next scheduled hospice team visit

Addressing Your Loved One's Symptoms

Pain

Managing pain is vital for allowing your loved one to live well during serious illness. Please see helpful tips below:

Give pain medications on schedule as ordered. Record times of breakthrough pain. Record doses so your nurse can determine when dosages need to be increased.
Provide comfort measures like massage, position change, soft music, ice, warm most compress, etc.
Notify the nurse immediately if your loved one is unable to swallow pain medications. Remember... Do NOT crush medications or open capsules unless instructed by the nurse.

Breathing Difficulty

If your loved one is experiencing shortness of breath or a feeling that they can't get enough air, please try the following:

Elevate the head of the bed and turn on oxygen if ordered.
Place your loved one in a position they say is most comfortable (side, back, raise or lower head, etc.).
Remove scented items from the room.
Do not smoke in your loved one's area.
Give medications as ordered.
Use air conditioner, vaporizer, humidifier, and/or fan (often a small fan directly on patient's face helps with severe shortness of breath).
Keep the room cool.
If pain is increased, give pain medication as ordered.
If your loved one's temperature is over 100 degrees, give Tylenol as ordered.
Check oxygen tubing for kinks.
Try to remain calm and reassure your loved one that this episode will pass.
Anxiety increases air hunger - soft music or relaxation exercises may provide relief.
Stay with your loved one until the episode ends. Notify the nurse if breathing problem continues.

Constipation

A major cause of constipation is main medications. Please use these helpful suggestions to ease any constipation your loved one may be experiencing:

Take stool softeners and laxitives as directed by nurse.
If there are no results in 2-3 days, notify the nurse.
Increase fluids if tolerated (water, prune juice, fruit juices).
Increase fiber in diet if your loved one can tolerate (bran flakes, bran muffins).
Exercise (even short walks around the house) if possible.
Administer Fleed eneme as ordered (nurse assistance available).

Agitation

Use the following calming tips if your loved one becomes restless, tense, or upset. Agitation is a behavioral, confrontational, physical disturbance that is, at times, a result of heightened anxiety and can also be a sign of uncontrolled pain:

Note: Personality changes can often occur with disease progression.
Talk gently; do not aggravate your loved one if they are confused.
Play soft music, watch TV, or sit with your loved one.
Check your loved one's safety (bed rails up).
Notify the nurse promptly if you feel your loved one is agitated.

Anxiety and Sadness

Feelings of anxiety or sadness are normal and expected during serious illness. Please let your care team know of any anxiety or sadness, so that we my help, and try the following to help your loved one:

Keep your hospice team informed (nurse, social worker, spiritual support counselor).
Listen. Just listen to your loved one.
Let your loved one feel what they feel... no matter what the feeling is.
Remind yourself, and your loved one, that there is no right way to feel - or be - during this time. Sharing positive memories or focusing on something upbeat is sometimes helpful.
Encourage your loved one to close their eyes and imagine a comforting place. For example: Picture a vast, green meadow. You are lying in the meadow and looking up into the clear blue sky and your body is very relaxed.
Encourage your loved one to take slow deep breaths.
Pray if your loved one wants to... and if you are comfortable doing it.

Nausea/Vomiting

Find helpful tips here for helping your loved one with nausea or vomiting. Nausea can occur for multiple reasons: Is it medication related? Occur after meals? Occur with movement? Smell induced? Anxiety-related? Notify your nurse if nausea is persistent.

For Nausea:

Offer small, frequent light meals/snacks and bland foods (Jell-O, puddings).

For Vomiting:

Record times to determine frequency and approximate amounts. If vomiting exhibits any blood or coffee-ground consistency, please notify the nurse.
Stop all food and liquids for at least 2 hours. Give ordered medication for nausea and vomiting. If your loved one is tolerating liquids, gradually add bland food, rice, toast, Jell-O.
If vomiting continues, notify your nurse.

Fever

If your loved one develops a fever, please try the following suggestions. (The thermometer may be placed under the arm. Add one degree to reading for temperature):

Notify the nurse if your loved one's temperature is 101 degrees or higher.
Lower room temperature, remove heavy blankets and clothes.
Increase fluid as tolerated (e.g., popsicles, ice chips).
Apply cool cloth to forehead, wipe arms and legs with cool cloth.
For temperature over 104 degrees, you may place crushed ice chips in Ziplock bags, wrap in thin towels, then place under arms and groin area for 5-10 minutes. Repeat every 30 minutes

Dry Mouth

Should your loved one develop a dry mouth, please use the following tips to offer comfort and relief:

Rinse mouth every two hours with saline (one teaspoon salt to one quart of water).
Offer liquids with meals to moisten foods and help with swallowing.
Give high-calorie diet supplements betwee meals as tolerated (i.e., Ensure).
Offer ice chips, hard candy, sugarless chewing gum,
Add liquids to solid food (gravy, yogurt).
Avoid spicy, hot, and acidic foods.

Gurgling/Noisy Breathing

Gurgling or noisy breathing often indicates a change in condition. Please do not hesitate to call your nurse. Here are ways to assist your loved one:

Adjust head of bed.
Position your loved one on side; changes sides every two hours to facilitate drainage (fi able).
Use mouth swabs to clean mouth; keep lips moistened.
If, after using the above measures there is no change, call the nurse.
This sound may be difficult for you and your family members to hear, but it's usually not stressful to your loved one and often occurs because throat muscles are very relaxed.

Everyday Care Tips

How can you help your loved one with their everyday care needs?

Check the caregiver tips below, and don’t hesitate to ask Samaritan Care Team for more training on any of these topics.

These skills, combined with the love and commitment of family and friends, can produce the very best results for the comfort of your loved one.

Hand Washing and Gloves

Hand washing is the most important way to prevent the spread of infection. Follow the helpful guidelines below to prevent infection:

Wash your hands thoroughly with soap and water beofre and after caring for your loved one, and before preparing or handling food. Wash your hands after removing disosable gloves or handling your loved ones's soiled linens or supplies.

How to properly wash your hands:

Rub soapy hands together vigorously using liquid soap (preferable anti-bacterial) and warm water for at least 20 seconds as youwork soap into a lather. Rinse thoroughly and dry using a paper towel.
Use of waterless, antibacterial gel is strongly recommended as an alternative to washing with soap and water. Rub hands together and allow to dry.

Disposable goves should be worn:

When changing solied diapers, pads, or linens.
When making any skin-to-skin contact, especially if there are any open wounds.
Anytime contact with bodily fluids or mucus membranes my occur. Bodily fluids include wound drainage, urine, stool, sputum, blood, and vomit.
When handling any soiled drainage supplies such as urine collection bags and ostomy pouches.
When taking and oral or rectal temperature.
Wehn cleaning spills involving body fluids or cleaning equipment soiled with body fluids.

Nutrition and Hydration

Nutrition is an important part of our lives from the time we take our first breath as infants. Your loved one’s appetite, however, may decrease during times of illness and recovery. Please read the helpful tips below on avoiding a food struggle with your loved one.

The body’s need for high calorie and protein foods may be altered during illness because of decreased activity, exercise, general metabolic rate, and the way the body uses food.

The most common problems many family members face are finding the right kinds of food and difficulty in getting the patient to eat. Too often this “food struggle” can develop into friction that will interfere with open communication in the family.

You may avoid this struggle by allowing your loved one to eat what he or she wants.

Offer small, frequent meals throughout the day rather than maintaining a three-meal-a-day routine.
Serve small portions so that your loved one does not feel overwhelmed or have a sense of failure because he/she cannot clean his/her plate.
Alter the times of meals to when your loved one is pain-free and has the most energy, i.e., morning, mid-afternoon, and after pain medication.
Blenderize family meals for loved ones who have a hard time swallowing.
Do not force food at any time. This can develop into a struggle where the family may feel rejected and the patient feels ungrateful or guilty.
Look for signs that your loved one does not want to eat. These may include coughing, biting the spoon, clamping teeth closed, turning the head, and spitting out food.

Please do not hesitate to ask your Samaritan Care Team for additional explanation or to answer any questions you may have.

Skin Care

Skin is your loved one’s first line of defense against infection. Read the helpful suggestions below to protecting your loved one’s skin.

When someone is confined to a bed or chair, frequent repositioning is essential. Reposition your loved one every 2 hours in bed and every hour in a chair to help prevent pressure sores.

Keep the angle of the head of your bed at less than 30 degrees when you are not eating or drinking.

Use pillows to protect against long periods of pressure on “bony prominences” (for example, between ankles, knees, behind back, under elbows, under calves to float heels). Tell your Samaritan Care Team right away if you notice areas of concern on loved one’s skin.

Mouth Care

Good mouth care is important all the time and becomes even more important when we are ill. Use the tips below to keep your loved one’s mouth clean.

Keeping your loved one’s mouth clean may help prevent aspiration pneumonia. Aspiration pneumonia is caused when a substance such as food, excessive saliva, or any foreign substance is inhaled into the lungs.

While doing mouth care, inspect the mouth and tongue for signs of sores or reddened areas. A flashlight can aid in this process. These sores not only cause discomfort and pain but can cause difficulty eating or drinking. Inform your nurse of white patches or sores in the mouth. You should provide mouth care at least three times a day, after meals and as tolerated.

Supplies:

Toothpaste or diluted mouthwash
Soft toothbrush or disposable oral swabs
Cup and bowl or basin
Lip balm
Face towel to protect your loved one’s clothing
Cool water, mouthwash (avoid alcohol-based mouthwashes as they can cause dry mouth), liquid saliva (available in pharmacies) or papaya juice

Procedure:

Always wash your hands before starting mouth care. If your loved one is unable to provide their own mouth care, you may assist by brushing their teeth with a small amount of toothpaste and a soft toothbrush. Assist your loved one to a sitting position or, if lying down, turn them on their side. Place a towel under your loved one’s face.
If your loved one has dentures, they should be removed for cleaning. Brush the dentures inside and out with a soft brush. Allow the dentures to soak for a while in water or denture cleaner. Assist your loved one in rinsing their mouth with water or mouthwash.
To prevent your loved one’s lips from drying apply some type of lip balm.

Changing Linens

At times, it may become necessary to change linens while your loved one remains in bed. Attempts should be made to keep the sheets fresh and free from creases and moisture. Please follow the steps below to keep your loved one comfortable and feeling fresh.

About an hour before changing linens or giving a bed bath, be sure your loved one has taken pain medication. This will reduce the discomfort of movement. If there are medication patches, be sure not to loosen them.

The thought of making the bed — with your loved one in the bed — can be overwhelming, but a nurse or home health aide will be happy to show you how it is done.

Supplies: Sheets and pillowcases, lift sheet, incontinent pads.

Procedure:

If you have a hospital bed, raise the bed to a height most comfortable for you.
Remove pillows (unless your loved one would be uncomfortable) and any top sheet/blanket. Turn your loved one to one side of the bed. Leave the side rails up on that side of the bed.
Go to the side of the bed with your loved one’s back facing you to loosen all bottom sheets.
Roll the bottom sheet(s), along with any incontinent pad, under your loved one to the middle of the bed.
Think of making the bed in two halves. Place a fresh sheet on the bed with the middle of the sheet in the middle of the bed. If you are using a lift sheet or incontinent pad, place those in the same way.
On your side of the bed, tuck in the sides, top, and bottom of the clean bedding. Then roll the other half of the clean bedding to the middle of the bed, tucking the roll (under the soiled sheets) under your loved one’s back and legs.
If the bed has a side rail, put it up and assist your loved one to roll towards you over the rolled linens.
Move to the other side of the bed and pull out the soiled sheets.
Unroll the clean sheets and incontinent pad. Tuck in the side, top and bottom.
Reposition your loved one so he/she is comfortable. Replace pillow and top sheet and blanket.
Put bed back to its lowest position.

Giving a Bath

A bed bath is a bath given to your loved one while he or she is in bed. People limited to bed become tired and restless, and bathing is crucial. It refreshes the body and the spirit, and it also provides comfort. Giving a bath in bed may sound hard, but it is actually very easy once you learn the techniques below.

Supplies: A big bowl with warm water, soap, two or three towels and a washcloth, a light blanket to prevent chills, lotion, and/or shaving materials, if desired.

Procedure:

Get the items you need.
Make sure you have privacy. Ensure that the room is warm enough for comfort.
Wash only a small part at a time.
Put a towel under the area being washed so you don’t get the bed wet.
Wash the area gently with a lightly soaped washcloth, rinse, and dry.
Start in the facial area and work your way towards the feet, washing the genital areas last.
Discard the water when it gets too dirty or soapy.
Wash your loved one’s back and do not forget to give a back rub. Back rubs are important because they provide comfort and often help decrease your loved one’s discomfort.
Apply lotion to your loved one’s back, arms, and legs.
Wash the genital area from front to back. Be sure to rinse well and pat dry with a towel.

It is very relaxing to place your loved one’s hands and feet in the bowl of warm water for washing. Remember to put a towel under the bowl in case of spills.

Our 24/7 Call Center provides you with the security of knowing help is never more than a phone call away – all day, every day.

(856) 596-1600

Providing Care at Home

Addressing Your Loved One's Symptoms

Pain

Breathing Difficulty

Constipation

Agitation

Anxiety and Sadness

Nausea/Vomiting

Fever

Dry Mouth

Gurgling/Noisy Breathing

Everyday Care Tips

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