Caregivers’ questions, answered

“It’s only with this project that I’ve been fully acknowledged as a caregiver. I find it hard to. Lots of people have it far tougher and extend themselves beyond what I do. There are many different versions. Millions and millions of people around the world doing some version of caring.” – Rebecca, caregiver for her mother, Harriet

Caregiving can involve many tasks in a single day. Similarly, no two days are the same, and at times you may wonder how you’ll get through it all. It can be helpful to create a care plan to help you feel more in control of the situation. A care plan is a collaborative document that is typically created by the caregiver, the person being cared for and a nurse or healthcare professional. Every care plan should be tailored to the individual. They commonly include personal details, medical information, wellbeing goals and a list of daily, weekly, monthly and annual tasks (these can cover areas such as administration, nutrition and hydration needs, medical care, social care and psychological care).

Acting as a planner and organisation tool, the care plan should help you understand what to do, and when. TENA’s helpful care plan guide contains everything you need to know to put your approach together.

Even in harmonious families, the person who became the default caregiver can feel overloaded with responsibility. It is important to resolve any family conflicts as quickly as possible to ensure your loved one receives the care that they need. Preparation and cooperation are key. Calling a family meeting and coming up with a care plan together is a great way to spread out care responsibilities. Try to be open and honest with family members about what tasks are feasible for you as a caregiver, and where you need support and for others to step in. If family disagreements become an increasing source of tension, you may need to bring in a third party such as a counsellor or mediator to help you resolve the situation.

With the cost of living rising, it’s important to know what financial support is available for caregivers. Benefits can be especially helpful for caregivers who have a low income, and those who are working or retired. Support for caregivers varies from country to country. Search online to discover more about government funding for caregivers to see if you are eligible for financial aid. In some countries, health insurance or sick funds can also provide financial support. Alternatively, you can reach out to caregiver organizations and charities who may be able to help you or point you in the right direction. For example, in some countries if your loved one suffers from incontinence, they could be eligible for some financial support towards their protection products.

When caring for someone, you’ll want to ensure that their living environment is comfortable and secure. You may need to adapt their home environment to minimize risk to their health and safety. For example, if the person you care for is semi-mobile or unsteady on their feet, you may need to install guardrails around the home, or a stair lift, to improve their quality of life. Make sure that the home is equipped for their personal needs. You may also like to consider adding extra light to provide more visibility over objects in your relative’s pathway. Minimizing risk in their living environment will also make your life as a caregiver much easier. If you care for a loved one in your own home, there are ways to adapt your living space without it looking like a hospital. Discover more tips about making your home more accessible in TENA’s Home Safety Guide.

Good nutrition and adequate hydration are vital for so many different aspects of health. Your loved one may depend on you not only for the provision of meals and drinks, but also for assistance with eating and drinking. When it comes to nutrition and hydration, there is no one-size-fits-all approach. Therefore, it’s important to consult a doctor or healthcare professional, who will be able to assist you with coming up with a tailored plan to help maintain your loved one’s physical health.

Caring for someone can involve a lot of lifting, handling and bending. You might need to help them get into or out of bed or assist them with getting dressed. Physically assisting and supporting someone in this way can be a daunting task, so ensure you are employing the right techniques when lifting your loved one, to protect both of your health and safety. General rules include:

• Never lifting above shoulder height
• Keep your feet steady and ensure a firm hold before moving
• Keep their weight as close to you as possible for an easier lift
• Ask your doctor or a medical professional for expert advice on how to lift your loved one according to their needs, and prevent any accidents

To find out how to make your caregiving environment more ergonomic for both you and your loved one, read TENA’s practical tips. You can also install aids like raised toilet seats in your home to make it easier to assist your loved one with mobility. Speak with a doctor or occupational therapist to find out more about ergonomic aids.

Supporting someone with mental health concerns can be really challenging, as a caregiver. If you are worried about your loved one’s mental health and wellbeing, it is important to seek expert support and advice from a healthcare professional as soon as possible. If they have a specific mental health condition, or are experiencing anxiety or depression, understanding the nuances of their diagnosis can help you give them the support they need.

In some instances, a person who needs help may struggle to accept the reality of their needs. Try to get to the bottom of their reasons for refusing help. Do they feel burdensome? Are they afraid of change? Is the loss of independence impacting their mental health? Once you understand their perspective and motivations, it will be easier to come up with a strategy that works for both of you. Whether it is framing suggestions carefully or having an honest conversation, taking an empathic approach is recommended when you meet resistance as a carer.

When caregiving, your body language and tone of voice are everything. The person you are helping will likely mirror a relaxed, calm and friendly approach, so try to maintain your cool, even in difficult moments. If your loved one is having a bad day, you can try to distract them by talking positively about things they like, special memories or things they enjoyed in the past.

As a caregiver, you may encounter moods shifts or difficult behavior from your loved one. This is very normal and can often be managed by giving your family member space, talking things through, making them laugh or distracting them, depending on the situation.

Generally, preventing challenging behavior is the best course of action. People who need care are more likely to experience feelings of loneliness and boredom that contribute to low moods. Encouraging your loved one to socialize with family and friends and (if possible) occupy their time with enriching activities such as going on walks, gardening, doing puzzles or brain-teasers can be a helpful way of minimizing challenging behavior.

If mood changes start to spiral or challenging behavior begins to occur on a more frequent basis, it’s important to find out why. Seek the advice of a doctor or medical professional if you are unsure what to do.

If your loved one has a condition such as dementia, challenging behavior is a very common symptom. When loved ones become angry or aggressive, it's not unusual to feel hurt or frustrated, but remind yourself that the behavior is a result of the disease and not the person's choice. Consider what you can do to help them, whether that’s involving a therapist or requesting outside help from social care. There are plenty of resources online that support to caregivers by connecting you to free support or advice over the phone.

It's important to find someone you can speak openly to about your experience. Apart from breaking the sense of isolation that often comes with being a caregiver, expressing your feelings to someone you trust can help you process your emotions and find the support you need. 

Caring for a loved one can be a positive and rewarding experience. It can also bring many challenges. It’s important to look after your own mental health and wellbeing as a caregiver. It is important that you eat nutritious meals, hydrate properly, get adequate sleep and exercise, keep an active social life, and don’t lose sight of your own personal aspirations outside of your caring responsibilities.

No caregiving situation is easy. You’re only human, and it’s natural to have days where you feel burnt out or overwhelmed by the process. It’s important to know that asking friends or family for help is not a sign of weakness. On the contrary, it can help you get the free time you need to relax. This in turn will help provide you with the energy you need to care for your loved one. Here are some of the common worries that caregivers report:

• Feeling stressed and worried about their loved one
• Struggling to find time for yourself and activities you enjoy
• Experiencing feelings of isolation and loneliness
• Worries about money
• Difficulty sleeping
• Experiencing feelings of guilt or frustration

“Normally, when people see me, they just see smiley Simone. And most people like to see smiley Simone because that’s how we are. We prefer cheerful people. We don’t want anyone dragging us down.” – Simone, caregiver for her husband James

If you are the primary caregiver for a loved one, it can be difficult for other people who are close to you to understand the weight of the responsibility and the daily challenges you face.

Although it’s not easy, don’t always paint on a smile if you’re feeling overwhelmed. Try speaking to your family to let them know when you are struggling or need extra help. 

“We moved out last week. You need to spread your wings and do your own thing. Now, I’m having a family of my own, but we will always be close. I don’t want my mum and dad to feel like we are just leaving and we’re not going to help anymore. We’ll always be there to help whenever we can.” – Chloe, caregiver for her sister Phoebe

Your caregiving role should not take over your life. If you decide to take on caregiving duties, it should not be at the expense of your own aspirations and dreams. If you feel like you need space or are missing out on normal day-to-day activities such as seeing your friends or keeping up with a hobby, this is a sign that you might need to reassess your care plan and share tasks and responsibilities with others. If this is not possible, speak to a medical professional who will be able to direct you to more support.

It’s normal for your relationship with your loved one to change or feel like a reversal – particularly if you are a young person looking after an older relative such as a parent or grandparent. Each of you might find the reversal of your roles hard to adapt to, or even embarrassing. Be prepared for initial awkwardness when your loved one needs help getting washed or dressed. And try to remember that although your loved one depends on you, it’s important that you make time to look after yourself too. To find out more about the type of support available, for young or new caregivers, check out TENA’s expert advice and tips on what you can expect.

Incontinence describes the involuntary loss of urine. There are a few different types of incontinence:

• Stress incontinence happens when you laugh, cough, or sneeze and is often caused by weak muscles that should provide support for the bladder and urethra.
• Urge incontinence or an ‘overactive bladder’ describes the frequent and sudden need to urinate with very little warning.
• Mixed incontinence is a combination of the two.
• Men with an enlarged prostate may experience post-micturition dribble, nighttime urination, a weak urine stream or frequent toilet visits.
• Post-micturition dribble is urine leakage that happens after a voiding, it is more common in men but can also affect women.

Speaking to your GP is the best course of action to determine the type of incontinence your loved one experiences. While speaking to a medical professional is the best way to confirm a diagnosis, TENA also offers information about the different types of incontinence and how to deal with them as a caregiver. 

Having incontinence doesn’t mean your loved one has lost control. After all, incontinence can happen to anyone. If your relative hasn’t already seen a doctor, make an appointment as soon as you can.

After confirming the diagnosis, a medical professional will be able to recommend a treatment or management technique for incontinence. They will typically recommend the least invasive solution first. Initially, this may involve lifestyle changes, physiotherapy exercises, or medical devices (see below). If those options fail, your doctor may refer them to a specialist.

TENA products have been designed to help manage incontinence easily. 

If the person you care for has incontinence, it’s crucial to stay on top of changing to protect their hygiene. Elderly skin is fragile, and incontinence can make it even weaker.

Knowing how to change your loved one’s products correctly will make the process faster and smoother, helping to minimize any embarrassment. If you are still unsure of what to do, seek the help of a professional, who can show you how to care for their intimate hygiene in a dignified way.

For most people, the normal number of times to urinate per day is between 6-7 times in a 24-hour period. Anything between 4-10 times is considered normal. To limit toilet visits at night, try to avoid drinking 2-4 hours before bedtime.

Urinary tract infections (UTIs) occur when harmful microbes make their way into the lower or upper urinary tract. UTIs are more common among people with incontinence, and women are more likely to develop a UTI than men. Many individuals with incontinence are older and may also be fragile and more prone to infection. The relationship between fecal incontinence and UTI is even stronger. Due to high bacterial content, contamination with feces is a major risk of infection.

Good caregiving means tailoring a solution to someone’s specific needs and preferences. Each care plan should identify the right toileting program, the right absorption level, the right type and size of product, and the right changing routine adapted to that person´s unique needs. It’s crucial to check your loved one regularly and keep intimate skin clean and healthy to prevent UTIs.

You can adopt the following practices as a caregiver to reduce the likelihood of your relative developing a UTI:

• Make sure your loved one stays hydrated and drinks enough water.
• Do not let them stay in wet products (i.e. with a high load of urine).
• Use incontinence products with materials that keep the skin dry, such as TENA pads.
• Develop a toileting routine and ensure your loved one completely empties their bladder and bowel every time they need to go.
• Avoid constipation and diarrhea. Ensure regular bowel movements by staying hydrated and eating enough fiber.
• Wipe from front to back after a bowel movement, to avoid transferring bowel bacteria to the urinary tract.
• Remove feces-soiled products immediately, from front to back.
• Avoid harsh soap in the sensitive genital area as it can cause imbalance and irritation. Instead choose gentle TENA Proskin care and cleansing products with a low pH (pH 4.0-5.0). This is especially important for ageing skin and sensitive skin.
• Use TENA cleansing cream to clean fragile skin, and TENA barrier cream for extra protection.
• Dry the skin gently after cleaning and before putting on a new incontinence product, since bacteria grow and thrive in moist areas. Ensure intimate skin gets air and ventilation to maintain skin health.

Many age-related diseases can trigger incontinence as we get older. Sometimes, accidents can be a one-off. However, if you notice your loved one needs the toilet more frequently, you may need to take steps to manage their incontinence. There are a few things you can do as a caregiver to manage incontinence outside of the home:

• Prevent unnecessary leaks by toileting frequently.
• Speak to a medical professional to get a proper incontinence diagnosis.
• Limit their drinking of diuretics (coffee, tea, alcohol) as too much caffeine may trigger urgency.
• Facilitate a nutrient-dense diet that facilitates regular bowel movements (thereby preventing faecal leakage).
• Always carry incontinence products such as TENA in case of an accident.
• Always carry a spare change of underwear/ clothes when you go out.
• If they struggle with nocturia try to limit fluid intake in the evening before bed (but do not allow them to get dehydrated).

Since there are multiple different types of incontinence products, you might wonder which one is right for your loved one’s needs. TENA offer a range of different incontinence products, so you’ll need to decide what type of absorbency level and how much protection they require. Size is equally important to consider. 

You can find TENA products in most supermarkets and pharmacies. Supermarkets usually offer a basic TENA range, with pharmacies typically having a wider offering. If a pharmacy doesn’t stock a particular TENA product, they may be able to order it for you from a wholesaler. You can also buy TENA products online.

Although caregiving is not without its challenges, there are lots of rewarding elements to looking after a loved one. At TENA, we want to support you in becoming a better, more confident, and happier caregiver. With years of experience in continence and skin care, we want to provide you advice and support that covers all aspects of caregiving. Find out more about caregiving for your loved one with TENA.

There are many factors that may influence the skin’s sensitivity. As we age, our skin naturally loses fat, growing thinner and weaker as a result, meaning cuts and scratches can take longer to heal. The good news is you can keep your loved one’s skin healthy and free from damage by using products that are endorsed by Skin Health Alliance and specifically formulated for sensitive skin. To learn more about caring for sensitive skin, visit the TENA Hygiene Guide.

Incontinence associated dermatitis (IAD) is a form of dermatitis that develops from exposure to urine or stool. To help maintain intimate skin health, ensure you are adhering to the toileting routine and changing times detailed in your care plan. Accidents can happen outside of this, so check your loved one regularly to ensure they are clean and comfortable. Maintaining intimate skin hygiene with TENA skincare products and good skincare routines can help keep skin healthy and protected. Observe the skin daily and inspect for any redness, itching or skin irritation which can be signs of IAD. As well as best practice skincare, adequate circulation and ventilation, good nutrition and hydration can keep genital skin healthy.

Bedsores — also known as pressure injuries — are injuries to skin and underlying tissue as a result of prolonged pressure on the skin. If your loved one is bedridden or immobile, they are more likely to develop bedsores. Fortunately, there are things you can do to prevent these issues and relieve discomfort. Reposition your loved one frequently to reduce pressure on the skin. You might like to invest in special cushions, or a mattress designed to relieve pressure. You can also protect skin from bedsores by changing incontinence products regularly and using barrier creams. Remember to check and inspect your loved one’s skin frequently for warning signs of pressure injuries or incontinence associated dermatitis.