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Bedsores also called  pressure ulcers and decubitus ulcers are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Elders confined to beds or wheelchairs for longer periods are particularly vulnerable to bedsores because of their limited ability to change positions. Bedsores most commonly occur on skin and around the body's bony areas, such as the tailbone, ankles, heels, hips, shoulder blade, spine, and backs of arms and legs.You might also notice that bedridden seniors are also prone to developing sores along the back and sides of their heads, including the ear rims. 

 Bedsore can be very challenging and painful for the elders. This painful skin condition can become debilitating and even deadly when left untreated. Unfortunately, bedsores can develop even with great caregiving efforts. Sometimes, elders are received back to their home or an assisted living home from a hospitalisation with a bedsore of second to third degree. 

**There are 4 stages of bedsores:**

- Stage 1: Redness on the skin
- Stage 2: Have a break in the top two layers of skin.
- Stage 3: Affect the top two layers of skin, as well as fatty tissue
- Stage 4: In this stage, the deep wounds may impact muscle, tendons, ligaments, and bone.

At Epoch, there have been times, we have received an elderly with bedsores, either from hospitals or from their own homes. 

**There are many reasons for getting bedsores, especially for elders which are shared below:**

- Prolonged lying down in the same position/lack of blood flow
- Absence of caregiver to change frequent positions every 2 hours

Other contributing factors include:

- Weight loss due to medical conditions
- Poor nutrition and inadequate hydration
- Excess skin moisture or dryness
- Incontinence
- Medical conditions which affect blood flow
- Limited mental awareness
- Frequent muscle spasms

**Treatment and management of bedsores:**

- Proper cleaning and dressing (an important part of keeping bedsore wounds cleaned, preventing infection, and promoting healing) 
- Pain management
- Antibiotics if required
- Changes in diet (high protein diet for healing)
- Incontinence management
- Muscle spasm relief
- Negative pressure therapy
- In extreme cases, surgery may be required 

**Prevention of bedsores:**

- Positioning of bedsores in case the elder is bedridden
- Use of air mattress or water air mattress
- Keep the skin dry and clean
- Frequent check of skin for redness 
- Maintain healthy diet

The best way to prevent bedsores is through frequent position changes, adequate maintenance of skincare, healthy eating, quitting smoking, and regular exercise. Pressure sores are a very serious and debilitating issue with the elders who have got strokes or are paralyzed. I’ve learned the hard lesson of not disregarding pressure spots on my resident’s skin as “not a big deal,” because every red spot and every mark has the potential to become a very big deal. Take care of your loved ones and prevent them from pressure sores!

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Management of bedsores for the elderly

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Do you know any inactive elderly who lack concentration? Do they struggle with normal memory recall?

**Let's gain a deeper understanding of the factors contributing to their situation.**

As we age, the cognitive abilities start to decrease. Problem-solving, processing speed, short-term working memory, memory and information retrieval, and attention problems are a few among these. A longitudinal study revealed that a cognitively active lifestyle that includes reading and information processing in old age may postpone the onset of dementia in Alzheimer's disease by as much as 5 years. 

Epoch understands this fact that dementia cannot be stopped, but progression from one stage to another can be slowed down by engaging the seniors in various activities. Cognitive exercises  for the elderly keeps them alert, thus reducing the risk or delaying the onset of **[age-related dementia](https://www.epocheldercare.com/epoch-dementia-care-program)**. Other main goals include enhancing quality of life by providing a sense of accomplishment, purpose, usefulness, or involvement; reducing agitation or wandering; enhancing a sense of self-worth and dignity; or fostering a sense of normalcy.

At **[Epoch Elder Care](https://www.epocheldercare.com/)**, we schedule various physical and cognitive activities for our residents as per the requirements of the stages, and each activity has its own defined purpose. All the activities are not applicable on all the elders as each one has had their own interests in the past.

There are many activities that are beneficial for the elderly to enhance their cognitive ability, which are as follows: 

#### **Drawing and Painting**

Engaging in creative activities stimulates the brain and aids in imagination activation. Dopamine levels in the brain have been found to increase during creative activities, making people feel happier overall. Encouraging the seniors to paint with water and pastel colors is a great choice for those with eye and hand coordination difficulties. This type of activity is a reflection of their emotion. 

#### **Playing Board Games**

An elderly individual with dementia may benefit from the mental stimulation provided by simple board games like Snake and Ladder or Checkers. They gain mental stimulation from the board games by fostering social engagement, problem-solving, and enhancing hand-eye coordination.

#### **Reading the Book Loudly**

A person may lose their ability to read due to certain **[types of dementia](https://www.epocheldercare.com/about-dementia)**. People with dementia who are unable to read for themselves can benefit when someone narrates or reads for them. It may be stories, articles, or anything else that they like to hear. Imagination is sparked in their brains by becoming a storyteller for them.

#### **Doing Crossword Puzzles**

The thoughts of your elderly loved ones can be kept occupied in a delightful way with puzzles. Like word jumbles and crossword puzzles, which train vocabulary expansion as well as memory and problem-solving skills. Word games Playing word games may help older adults' cognitive function, according to a recent study. Scrabble is an example of a competitive game that not only offers these advantages but also promotes social interaction. 

#### **Volunteering**

Engaging in volunteer work significantly improves the health and happiness of the elderly. The act of volunteering brings tremendous benefits to the overall wellness of senior citizens. The wellbeing of older adults experiences significant positive effects through their involvement in volunteer activities. Participating in volunteering has a profound impact on the physical and mental health of the elderly.

#### **Meaningful Conversation**

Conversation with others is one of the most crucial cognitive exercises for seniors. People frequently become more reclusive as they get older, which limits their opportunities to talk to others about the things that are important to them. You can engage their minds and uplift their spirits by asking them what they think about various scenarios and occurrences. 

##### **Conclusion**

These are some of the activities that we as caregivers can do to keep the elderly cognitively active. Not every elderly individual likes to participate in the activities, but we try to engage them when they are comfortable. At **[Epoch](https://www.epocheldercare.com/)**, we try to engage elderly in various activities during the daytime based on their interests, and when it seems that they are happy with it, we further offer them meaningful activities on a day-to-day basis. It is important to note that elderly may not be actively participating, but observing others is also cognitively stimulating.


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6 Activities to Boost the Cognitive Ability of the Elders

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There’s the music of sarod playing in the background while I write this, helps me write my memoirs!

When I was a child, I used to write diaries. What’s enticing to me at that point in time was the smell of new vintage-looking pages, and a unique feeling to ink it down. It all started then. Who knew the passion for writing would grow so strongly on me!

Hi, I’m Sneha, Business Assistant & Content Writer at Epoch. Yes, I own these words and wear them with pride. The journey to earn this was pretty savage, and I’ll like you to be a part of this! Hence, sharing a page from my memoir.

It was the dawn of the year 2020 when I promised myself to come out of the University with a Mass Communication and Journalism degree in one hand and a placement in other. Things started turning upside down when the covid wave came along and washed away all the aspirations I had of starting my career in a corporate world. Later that year, after graduating, I started freelancing.

Little did I know that the universe had something else up in its sleeves.  On 1st Feb, I started my journey at Epoch, and it’s already a year now! I’ll need pinches from myself to believe so. When I stepped out of my comfort zone, came to a new city, I met amazing people, especially women, who inspired me in the most unusual ways. It is my sheer luck and fortune that I landed in Epoch right after college. The journey of amazement and learning didn’t stop for me, I would say.

How often does it happen that a CEO of an organization holds your hand, mentors you, and walks you through your journey? Well, happened to me and to all those who started anew! Here, at Epoch, I saw myself under the guidance of domain experts. From each one of them, I learnt something, both applicable in personal and professional lives. My team pushed me one notch beyond my threshold, surprisingly that brought different colours to my work. To date, I am told to be the owner of not only my projects, but also my decisions, successes, and failures. I am learning.

Epoch has played a vast role in shaping me into Sneha 2.0. If you know me and don’t believe, let’s go out for a cup of coffee! A confident and radiant Sneha, you’ll see.

Epoch homes abode elderly those who need dementia care and assisted daily living support. When I started, I was briefed about dementia but the understanding of the daily life of a senior 75+, came to me when I was in their presence. Recently through one of the Epoch webinars, I heard a doctor/geriatrician say, and I quote, “there’s a person still behind the dementia patient”, and this made me realize how naïve are we to not notice this in our elderly loved ones!

Amidst the pandemic, there were fewer interactions with our elderly residents, regarding their own safety. But whenever I got the chance, covered in PPE kit, I would jump to know each one of them. With some I sang era old songs, with some I recited poems of Harivansh Rai Bachchan, Dinkar, Nirala, with some I learnt the concept of perspective, with some I learnt fashion, some taught me to live life with a bang, and that’s what I am doing!

Epoch in a way turned out to be a blessing in disguise. I would like to stop the roller coaster of my emotions here by simply being grateful. One day, when I close my eyes, I would love the memories with Epoch to roll in the cassette of my life. 

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To Epoch, a cassette of my life

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I want to share my unique professional journey with you. Personally, I have been someone who is always up for trying new things.

In August 2014, after completing my training as a General Duty Assistant, I got placed at Epoch Elder Care as a care attendant.  Even though I had prior care training, being a care attendant in an assisted living home was new for me and there was much to learn, especially about dementia care. At Epoch, everyone is encouraged to ask questions whenever they do not understand, your colleagues and seniors will answer them patiently and help you understand your issues. I realised how tough life can be with dementia and at Epoch I was able to increase the quality of life of elders with dementia and this was very satisfactory for me. 

Given my inclination to try new roles, back in 2018, I was chosen for the role of Admin Assistant which was a huge change for me professionally as I was moving from  care to an administrative role. With much support of senior colleagues, I was able to manage this role with confidence. Here I learnt new skills like vendor management, maintenance planning, and working with multiple departments. Being an ex-care attendant, I was able to understand the importance of this role where I had to ensure the upkeep of Epoch homes and how crucial it was for our care attendants to take care of our residents. Iss dauran maine apni life ko bahut hadd tak personally, professionally and financially grow bhi kiya hai (During this time, I was able to grow personally, professionally and financially). 

Then in January 2020, I saw an opportunity to move to a new role within Epoch as a Human Resource (HR) assistant and I confidently took the leap. Given my prior experience as a care attendant, I was quickly able to connect to prospective candidates for Care Attendant role and understand who could be a good fit at Epoch, and I learnt the aspect of people management. Ab dedication and guidance of my manager and colleagues ke sath grow kar raha hun or hope aage bhi yun hi grow karta rahunga. (With the dedication and guidance of my manager and colleagues, I am learning & growing  ,and will continue doing so!)

Thanks to Epoch, I have been able to understand this industry well and grow myself professionally in many different perspectives by gaining many new skills.

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Trying new roles and gaining new skills at Epoch

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I want to share my journey so far with Epoch Elder Care. I started my journey as a care attendant with Epoch’s Monet house at Pune location on 15th May 2016 and sab kuch naya tha mere liye (everything was new to me). It was a great year well spent at Monet house; and bohot kuch sikhne ko mila (great learnings came along). Under the guidance of our Facility Managers and Facility Nurses and other care attendants, I was properly trained to look after our residents. Epoch work culture bohot welcoming and unique tha mere liye (Epoch culture was welcoming and unique for me) - where the team was great & they treated me like a family member. Not only this, the relationship and bond I developed with residents was an amazing feeling. The concept of dementia and its management was something jo mujhe dhire dhire samajh aya. (The concept of dementia and its management was something I learned over a period of time).

After the completion of one year, the management decided to transfer me to Epoch’s other home (Vermeer House) in Gurugram. I was happy with the decision for two reasons. Firstly, my learning was about to expand and secondly, my hometown was nearby. After working as a care attendant for a year and a half at the Vermeer House, the management decided to promote me to the role of Head Care Attendant. Finally, my dedication & honesty paid off. My responsibilities increased and I had to oversee all errands related to our residents, other care team members, and the house overall, which I enjoyed throughout.

Then again on 1st May 2019, I was offered a role change based on my skills and eagerness to work. This time the management decided to offer me the role of Admin Assistant, which I accepted confidently. It was challenging at first, but with the constant guidance of the then corporate team, I managed with quite ease.

Epoch has not only helped me professionally but also personally. It is here that I met Sarita (Care Attendant at Vermeer House), married her and started another chapter of my life. She is always there to support & motivate me. 

During the outbreak of COVID-19, around Feb 2020, I was handed over the role & responsibilities of an Office Assistant in the new Vermeer house at Gurgaon. Covid ke first wave me hume bohot kuch naya experience karne ko and samajhne ko mila. Ye time humare liye bohot difficult tha but hum sabne milkar Epoch and ek doosre ko sambhala. (New learnings came along whilst managing and experiencing the first wave of coronavirus. It was a difficult time, but we managed to pull through). I was presented with the COVID warrior award. Epoch ke saath ab itne memories jud gaye hain ki yahan har koi apna sa lagta hai. 

Epoch me hamesha kuch na kuch naya sikhne ko and samajhne ko milta hi hai and mere liye bohot unique experience banta raha hai.

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My journey of multiple roles at Epoch

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Epoch - A name that defines an era of development and sweet memories and after spending 6 months here, I believe this place truly justifies its meaning. 

I am Aditi and I manage “On-Boarding and Customer Relations” at Epoch Elder Care. In my 6 years of work experience, I was always into Relationship Management roles and had predefined goals and KRA’s, which are standard across most industries. For a long time, I was looking for something new, something challenging and something refreshing. I came across Epoch in the most unprecedented times possible, I was going through a lot of lows in my life personally and professionally and somehow I started to feel that I kind of lost the meaning and purpose in life. Little did I know that I would love each day at work here. 

My last 6 months at Epoch Elder Care have been really enriching. They were full of highs and lows and I almost feel like I have been a part of the company since ages - great energy around and amazing people to work with! They are more than just coworkers, there is a lot of respect and kindness for each other, and the company culture encourages meaningful interactions between colleagues. I think the best part is that everybody’s work is co-related and you are aware of everything that is happening in the organization. Your focus is not just your work, it’s also how we could improve together as a unit. Each team member has immense opportunity to work outside their predefined roles. We are all often working together and there is an emphasis on brainstorming, feedback and innovation. People are highly adaptive and so open to feedback.

In India, sending parents and grandparents to an Old Age Home is considered a taboo and I think my knowledge about such facilities was just restricted to this wide held notion. I did not know that a concept of “Assisted living, Dementia care facilities” actually exists in India. After coming here, my perspective towards life changed 360*. I think I have grown a lot as a person in such little time and I am learning everyday. 

Coming from a joint family background, I always wanted to do something for the elderly and I feel so overwhelmed to be a part of such a great cause. It's a different world altogether. People are extremely empathetic and helpful towards everybody’s needs and are just so full of love. They go all out to provide the utmost level of care to any elderly staying here. Nobody is a “Patient”, they are all Nana, Nani, Aunty, Uncle, Dadi and Dadi for everyone. It feels like I found another joint family for myself! 

The work we do here is so different and extremely personalised. Coming from a sales background, I struggled a bit in the beginning with the way we write emails, the way we respond to our clients, the way we greet and meet them. It is all so crucial to us and that is how we differentiate ourselves from others. I am still learning and trying to be on top of things. This work really keeps me on my toes, but I like where it is taking me. 

My role is not just restricted to making sales and generating revenue. In fact, it's just the other way round. For me, it's not about selling something, it's about earning every ounce of love and respect that we receive from our residents and their families. We do think of a larger picture, but only after capturing and enhancing the smaller ones. I connect with so many people everyday and am touched by their stories. The only thought which comes to my mind is how can we make their lives better and beautiful. Listening to our residents and spending time with them, makes me feel a little more human and I am taken back to those golden times with my grandparents. I feel I belong here and I definitely feel destiny played a big role. 

When at the end of the day you go back home thinking, you made a family happy and they bless you with the most kind words possible, trust me, it's all worth it! I am glad Epoch happened in the times when I needed it the most and it’s making me a better individual with each passing day!

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“Earning” is far more important than “selling”

Bedsores also called  pressure ulcers and decubitus ulcers are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Elders confined to beds or wheelchairs for longer periods are particularly vulnerable to bedsores because of their limited ability to change positions. 

Management of bedsores for the elderly

Prasita Nair , Head Of Clinical Operations

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