Good records for good results

The need for current and complete records is paramount in just about every area of our lives.  From taxes to grocery store receipts, it’s just a matter of time before you are going to need to trace your steps or transactions to take care of your daily business.  So how can we keep it all straight?

paper organization

Formally speaking, the folks at “For Dummies” (think Microsoft Windows For Dummies) have a great list of suggestions for our important documents.  Check them out here.

But what about all those stacks of paper, folders, and boxes?  How about those electronic files in your email and other folders in too many accounts to track easily?  As a person who regularly spends time organizing my life, I would say use what system works best for  you and stick to it.  Do a little every day.  Handle a document as few times as necessary before filing it or acting upon it.  Even if you need to drag-and-drop electronic files into a folder marked by a subject or month of the year DO IT!  And if you haven’t touched the item in a year and it is not something of vital importance then either place it in a covered, plastic bin marked with the year in the attic or basement OR toss it!  View the electronic file and re-classify it as necessary or dump it into the Recycle Bin.  You will know what to do with it when you have to move or get a new computer!  Sometimes things are just too emotionally charged to make a decision right away anyways.  I get that.  So into a “bin” it goes!

The desk in our home only holds records for the current and past year.  The file cabinets get purged yearly (yes, we have a lot of them!).  The clear, plastic bins in the attic get purged every 7 years if not sooner.  And just about anything that can be reconstructed online (such as a bank statement) is shredded by the end of the year, keeping a master copy as a summary for the year.  That summary is put into our shoe box of tax documents, receipts and any paper planners that would help to reconstruct an event or decision from the prior year if needed.  But hey, this is not legal advice (and may not apply to truly legal documents) just some thoughts for one’s sanity!  You decide what works best for you, k?

The single best system for organization of our day-to-day records has been the envelope system.  We use a set of business-sized envelopes labeled by subject to keep track of receipts for a given year.  The envelopes are kept in a metal “money box” from an office supply store.  Tax time is less hectic for us when we can pull out the envelop marked “Donations” to add up for our itemized deductions.  File folders and spreadsheets work well too, just have some kind of paper trail to support the latter.  If documents are scanned, I have heard that it is prudent to have a 3rd location to store documents in case your hard drive fails (like Dropbox or and external hard drive that gets updated automatically each week.  Just some thoughts.

Another example is the management of medical records at our house with the use of one travelling notebook for each person.  For those with ongoing health issues, the most current reports, treatment protocols, medication/supplement lists, questions, billing issues, etc. are kept in one place for quick reference during a medical appointment.  (Other folks may keep a dedicated spiral notebook-with-pockets or note-taking app for this purpose.)  Sometimes I’ll just add the issue needing to be discussed as a note in my smartphone calendar too.  When there is a special appointment with a new medical provider, we can easily retrieve the information needed, saving valuable time and hassle from having to follow-up with everyone later.  “Do it now” is the best strategy IMHO when at the office or location of the service provider.  Periodically the notebook gets purged into more long term files in a file cabinet; test results are kept and billing records eventually are tossed after 3 years.

These organization systems are critical for those in the role of a caregiver.  Or an executor of the estate of a loved one.  Or when teaching these skills to our next generation!  I will always be grateful that my mom was a bookkeeper for she kept bankers boxes of records long before there were computers.  Since there will always be paper records, having a system for organizing every type of information is necessary and valuable for making life easier.

Julie, O.T.

P.S.  Here are more details if needed!

Res and Rec: Toileting Accessibility Made Easy Part 2

I recently read a blog from The World of Accessible Toilets explaining for folks in the United Kingdom, who is entitled to use the accessibly-designed bathroom stall in public places.  Oh my.  Here in the States, I admit that I have often used the accessible stall!  I have not seen guidelines on this from the Americans with Disabilities Act which was revised in 2009.  Perhaps there is case law out there that will find me guilty:  of doing market research?  marveling at how ridiculously low “accessible” toilet paper dispensers can be?  musing at the narrow doorways and flimsy door latches that certainly do not meet the standards?  O.k.  I will stop TODAY.

In Part 1 of this topic, we explored how to reduce the effort, improve the ease of use, and diminish the risk for falls when using this area of the bathroom.  Since the bathroom is one of the most dangerous places in the home, it makes sense to examine how to make all of the activities completed there safer.  In future blogs we will explore bathing, grooming, hygiene, and organization of this space for persons of the Baby Boom generation.  This practical information may be of use to us or to a loved one entrusted to our care.  So let’s finish this necessary topic with Part 2!

Reservations

My first reservation is this:  If you find that you are using grab bars in public bathroom stalls, get busy on taking care of your health and joints TODAY.  For example, strengthen your quads by practicing squatting without support if it is safe for you to do so instead of risking those muscles becoming weaker by pulling yourself part of the time.  My second reservation if you are truly benefitting from simple modifications in public places, consider adding them to your own living environment.  A few changes may help you to use less effort in the bathroom (and save it for other activities), improve your body mechanics, and reduce your risk for falling.  Even our grandchildren will benefit!

And third, if a person already has a bedside commode available, try adapting it as follows before purchasing additional equipment.  If you don’t mind the aesthetics of a “potty chair,” you just may like the flexibility it provides when faced with temporary illness or surgery.  For bariatric applications, often a commode placed over the toilet is more stable than a device that is attached to the toilet.  Adding grab bars to the wall is always a great idea no matter which type of equipment you choose when making toileting more accessible.

Recommendations

For persons who are bedbound on a short or long term basis, a bedside commode is very helpful.

“All-in-one (3-in-1) bedside commodes, can be used to assist a person who has difficulty in walking to the bathroom by bringing the toilet into the bedroom. This type of commode can also be used over an existing toilet, like a raised toilet seat, which raises the seat height and assists the user in standing.” (http://www.apparelyzed.com/disability-equipment/showerchairs-commodes.html)

Often a portion of the price of a commode is reimbursable from your insurance provider when billed by a home medical equipment supplier:  1) when the person is bedbound or 2) the person cannot access the bathroom without assistance. (Check with your local Home Medical Equipment supplier for the current regulations.) Also see our Checklist for Used or Donated Bath Equipment before obtaining pre-owned equipment from a garage sale or lending closet; you can often save a great deal with these tips!

Bedside. Place the removable bucket on the frame underneath the toilet seat on the commode then adjust the height with the pins on the legs as follows. Like sitting in a desk chair, sitting with the hips/knees/ankles are at 90 degrees (think corner of a box) puts less strain on the low back and makes it easier to rise to a standing position. When the hips are lower than a person’s knees, it is harder to rise from sit to stand.   Now place the commode at a 90-degree angle right next to the bed for best use. Collapsible armrests are available to ease “transfers” to/from the commode using a scooting motion. With a collapsible armrest, you can lower the armrest down and not have to hike up your hips and bottom as high when moving from the bed to the commode and back again. If the bed and the commode are the same height, you can scoot sideways more easily with the armrest out of the way.

In the bathroom.  A very handy application of a bedside commode is use it like a toilet riser by placing it over the toilet in the bathroom.  Just lift up the toilet lid and seat first!  The commode instantly raises the seat height and provides handholds for safe transfers. To use the commode over the toilet, simply remove the bucket from underneath the commode and use the plastic splashguard instead.  (This is usually stored inside the bucket in a new bedside commode.)  The splashguard is a plastic ring that looks like the commode bucket with the bottom cut off. It is held in place by the frame of the commode and keeps things neat and tidy when the commode is in use.  Again, make sure that:

  • the toilet seat height is appropriate for the primary user with consideration to others in the home that will also use the bathroom and
  • 2) NO rug or mat is placed under the legs of the commode. It is important that the commode be level underfoot and make direct contact with the floor.

Be sure to check the weight limit for the commode and follow the manufacturer’s recommendations. Bariatric toilet risers and commodes are available; purchase a chair that is rated well above the weight of all of the users in the home.  Now you have seen the 2 primary uses of a “3-in-1” commode:  over the toilet, bedside; the 3rd is as a shower chair.  Hold that last thought for a moment!

The bedside commode when used with the lid closed may also function as a bathroom vanity chair as well. Simply place the commode in front of the sink for use as a chair during personal hygiene and grooming. Sometimes opening up the cabinets below the sink (or replacing the doors with a fabric covering) can provide extra leg room or access to storage for items in lower cabinets within easy reach.  And to use it as a shower chair, 1) remove the bucket or splash guard underneath the commode, 2) check the seat height when the person is sitting inside the tub or shower stall, 3) adjust the legs accordingly, then place it inside the bathing area.  (Be sure to “FOLLOW” us for future tips on making bathing more accessible including use of hand held showers, grab bars, non-slip mats, and more in future blogs!)

So there you have it:  an in-depth review of strategies to ease the comfort and safety using a bedside commode for toileting and more.  Refer to Res and Rec:  Toileting Accessibility Made Easy Part 1 for discussion of grab bars, safety frames, raised toilet seats, and “donut” risers too.

Please note that this information is intended to be a guide and not a replacement for an individual home safety assessment by an Occupational Therapist or Certified Age in Place Specialist.

Take care, Julie O.T.