Yana Swainson is the operator of senior care agency, Bermuda In-Home Care. She has more than three years of experience personally caring for seniors, and is uniquely qualified to comment on the state of senior care in Bermuda.

What do you think is the most common problem affecting Bermuda’s seniors today?

I would say it’s related to activities of daily living, or ADLs. Getting in and out of bed, bathing, dressing, eating and taking care of personal hygiene are some examples. These activities are essential for living. There are also tasks such as housework, taking medications, money management, using a telephone and transportation within the community — not always vital but still necessary for good quality of life.

Can you tell us why some seniors may have difficulties taking care of themselves?

Age by itself is not necessarily a factor. Many times, it is possible to point out a specific reason for difficulties with ADLs. Some examples include depression, dementia or other mental disorder, physical illness, consequences of falls or surgery and loss of vision or hearing. The likelihood of difficulty with ADLs goes up with age, and the problem can be more serious for seniors who live alone.

Certainly seniors who have these difficulties ask for help?

The sad truth is that often, they do not. Seniors may be in denial about their situation, or be embarrassed to admit it. Also, people with dementia may not even realise a problem exists, and therefore not seek help.

How does one recognise that a senior is having trouble coping with daily activities?

Staying alert is key. Family members should carefully watch for any signs of neglect and other changes. Inadequate personal hygiene is often a telltale sign; for example, dirty clothes, body odour, bad breath or neglected nails. Unexpected weight loss may be due to inability to obtain or prepare food. Stacks of unopened mail, unpaid bills, mishandled finances and disorderly house are also concerning. Stopped participation in previously important activities, such as playing cards or dining with friends, also offers a clue.

How can family members help, once they recognise the problem?

The first step is to take the senior to a doctor, in order to check for a treatable cause. Addressing a treatable cause can often restore function — for example, doctors can treat dementia and depression. If, despite treatment, a senior still needs assistance, a doctor can recommend the needed level of care. If family members feel comfortable and are capable of caring for their loved one, they can do it themselves. If family members do not have caregiving skills, they can call a caregiver agency and ask for a training session with a professional caregiver. Sometimes, nursing homes and agencies offer free lectures; these can be worth attending. If family cannot care for their loved one, they will need to retain services of a professional caregiver.

Can you offer some tips for selecting a caregiver?

I would hire only certified caregivers. They have successfully completed a training course and have the skills to care for seniors in a dignified and sensitive manner. It pays to thoroughly check at least two or three references. While new caregivers have the required training, I would look for at least one year of caregiving experience. A word of warning: do not blindly hand over all responsibilities for your loved one’s care to a caregiver. Visit your senior family member as often as possible, and check on their condition — are they well groomed? Is their weight reasonably stable? Are their linens clean? Is their skin free of bruises and scratches? Do they eat nutritious meals, drink enough fluids and receive their medications regularly and on time?

Contact Ms Swainson via e-mail: bihc@northrock.bm.

Dr Serebrennik is a physician by training and now a full-time entrepreneur, investor and writer. He is also co-founder of Lighthouse Medical Supplies, Ltd, a local company dedicated to helping healthcare providers cope with the increasingly competitive and cost-conscious practice environment.