Caregiver to Caregiver

Autumn is my favorite season…for now. When frosty winds whirl snowflakes in the sky come December, that will be my preferred time of year; and when the buds color the trees in pastels and the daffodils and tulips spring forth in brighter hues (especially the fragrant lilacs on my mom’s ancient bush), then I’ll declare the March-April-May triune as my choice of the four. What about summer? To tell you the truth, summer was a lot more fun when I was younger. Heat and humidity zap my energy and I do not need any more reminders that I am growing older. There are pleasant (i.e. lazy summer days on the beach) and less enjoyable (i.e. ice storms in winter) aspects of each season; but I must admit, just knowing there will be changes in the weather and scenery every three months is rather appealing. 

The meteorological conditions this past week here in the piedmont of North Carolina have been delightful. Finally, the sweltering temperatures have abated, and the gentle breezes have provided conveyance for fluttering autumn leaves. Ah! I have begun and ended most days on either the screened or front porch, enjoying the gifts of nature.

Just when it seems that autumn is the perfect season, we are bombarded with reminders that flu season is on its way – or already here.

As I watched a few news programs last week, at least four times the person being interviewed experienced an uncontrollable coughing fit. Instantly, the cameraperson switched to the interviewer, but the hacking coughs could still be heard in the background. One interviewer could hardly control her laughter, but the “expert” continued his diatribe, barely able to hold the coughs in, until he was almost blue in the face. Seemingly amused (or maybe embarrassed) she went to an early commercial break. These incidents were a reminder that ‘tis the season of colds and flu.

As caregivers, we need to protect our loved ones as best we can from contracting the flu. Between 2010 and 2016, according to the Centers for Disease Control and Prevention, a range of 12,000 to 56,000 died each year due to flu; many of them were over the age of 65. Up to 70 percent of flu-related hospitalizations are seniors. Persistent conditions such as chronic obstructive pulmonary disease (COPD), diabetes, heart disease, liver and kidney disease or cancer can make seniors more vulnerable to the flu, as can a weakened immune system. 

Let’s review some flu facts before talking about ways to avoid this possibly serious or even life-threatening ailment.

Flu, of course, is short for influenza. (I know you knew that but you would be surprised how many people do not.) The most common type is Influenza A which causes most epidemics (localized spreading) as well as pandemics (worldwide spreading). This strain infects humans and animals including wild birds that can carry the illness across continents. Influenza B, together with influenza A, contributes to about 20 percent of annual infections. This strain survives only in humans and seals. Influenza C is the mildest and is passed among humans and pigs. Since epidemics do not result with Influenza C, the flu vaccine does not protect against this variety. 

Influenza is considered preventable. Many health professionals consider the best method to keep the flu from visiting your home is a flu shot – for you and your care recipient. Always check with your loved one’s health care provider to make sure there are no contraindications for receiving the vaccination. You can research these online, but still discuss them with the doctor. You will probably see “a history of Guillain-Barr syndrome” on this list; in fact, the release form I signed clearly noted that. However, after recovering from Guillain-Barre in the summer of 2018, my neurologist at Duke University gave me the okay – noting that the benefits outweighed the possible side effects (based on current research). I had my shot in 2018 and again this year without complications…neither have I had the flu. 

There are also common-sense steps you can take to prevent the flu. These include:

• Practicing consistent good hygiene habits including regular baths, wearing clean clothes and particularly washing your hands properly (use warm water and soap, lots of rubbing, rinse well and dry), especially after using the bathroom and before eating.
• Keep hands off of your face – the mucous membranes of the mouth, nose and eyes are portals of entry for flu germs.
• Use antibacterial wipes to clean frequently touched surfaces in the home such as doorknobs, remote controls, and phones.
• When in public places, be aware of harbingers of flu germs. I no longer visit buffets for two reasons: way too much food (usually unhealthy) and germs! The last time my husband and I went out to our favorite Indian restaurant, I was enjoying my vegetable samosa and saag paneer when a husky biker sauntered through the door. Heading straight for the buffet, he sleeked back his almost-waist length stringy hair with his right hand, pausing to scratch a bald spot on top. He patted the edges of his horseshoe mustache with both hands, then gingerly ran his hands through his ample beard. Slipping his helmet over his left forearm, he picked up a plate in his left hand and began piling on the selections, grasping each serving spoon, in turn, with his right hand. I gasped. I looked away from the pillaging. I had a revelation. Restaurant buffets are a petri dish for germs. 
• It is not only restaurants that expose you to germs; vigilance should be practiced in any public place, especially during flu season. Do be careful about touching surfaces where germs may linger such as grocery cart handles, door handles, faucets and toilet flushers in restrooms (well, actually an surface in public restrooms), and plastic or metal surfaces such as counters and tabletops. If sanitary wipes are provided, use them. If not, carry your own. Flu viruses can live on these surfaces as long as 24 hours.
• Instruct your love one (or assist if needed) to cover their noses and mouths with a clean tissue when sneezing or coughing. Afterwards, dispose of used tissues in appropriate receptacle and wash hands. If a sneeze or cough sneaks up on you when you do not have a tissue, it is supposedly acceptable to sneeze/cough into the inside of your elbow to protect others from your germs. I do find this measure less than desirable; I suggest stocking up on tissues. Flu germs can spread about six feet by droplets from the mouths or noses of people with the flu to the mouths and noses of those nearby; it is even possible to inhale flu viruses. So after reading this, you may want to…
• Limit unnecessary trips to crowded public places during the height of flu season. Avoid close contact with other family members or visitors who may have the flu.
• Sometimes the flu strikes even if you were vaccinated and practiced precautions. Research shows that having been immunized may, however reduce the severity and length of your flu episode. If you do get the flu, if at all possible, find someone to take over your caregiving responsibilities for a few days. This varies, but someone with the flu is usually contagious from one day before symptoms start until about a week after it hits. Not only do you want to protect your loved one from your germs, but you need to rest so you can recover more quickly.

Almost all flu strains cause similar symptoms, which vary in severity. These may include:

• Constant cough
• Runny nose
• Fever (please do not say temperature- every living being has a temperature; an abnormally high temperature is a fever)
• Sore throat
• Chills
• Body aches and discomfort (include muscle cramps and headache)
• A few people may also experience gastrointestinal issues such as nausea, vomiting or diarrhea

Some of these symptoms are also indicative of the common cold, which is less severe and lasts for a shorter period. It is time to check with your doctor when these symptoms continue for several days or if they get progressively worse. Anytime your recipient already has serious health concerns, the doctor should be notified if flu symptoms occur. 

Complications of the flu include pneumonia, bronchitis and sinus and ear infections, so close monitoring is needed once a flu diagnosis has been made.

Another effect of the flu, especially among the elderly, is dehydration. Because seniors already have 10 to 15 percent less water in their bodies than when they were in their prime, dehydration can occur quickly. Offering and encouraging fluids is essential. If they balk at their usual liquids, be creative: popsicles, fruit slushes, spiced hot tea or broth may be more appealing. Monitor dehydration by checking skin turgor: (pull up the skin on the back of the hand and hold for a few seconds; properly hydrated skin should return to normal quickly while dehydrated skin “tents” or stays in place. Other signs of dehydration may include confusion, dizziness, dry mouth, sunken eyes, rapid pulse, decreased blood pressure, and low urine output. Again, if you suspect dehydration, notify your care recipient’s heath care provider right away; dehydration can have serious consequences..

May your autumn be filled with colorful falling leaves, crisp mornings and cool, breezy evenings – and an absence of the flu bug. Now that would make for a wonderful season!