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Please read carefully before your first shift. This guide covers everything you need to know.
The house is less than a five-minute walk from the LIRR — easy to get here and to leave.
| Age | 94 years old |
| Lives with | Her grandson, who is home most of the time |
| Mobility | Walks with a walker — always stay close to prevent falls |
| Hearing | Mostly deaf — communicate using Live Transcribe app, lip reading, or gestures |
| Vision / Reading | Can read perfectly — printed signs are posted around the home |
| Cognitive status | Dementia — short-term memory issues; repeated questions are normal |
| Personality | Sweet, social, and emotionally perceptive — she responds to warm energy. She can be resistant or even rude toward someone new at first. This is not personal. She does warm up. Patience and consistency are what work. |
Find the grandson or another responsible person, ask them directly to watch her, and wait for them to confirm before you leave. A verbal "I've got her" is the handoff. Anything less is not.
Never assume that because she is in a room full of people, someone is watching her. A busy or social environment is not a substitute for active care. Stay attentive no matter who else is present.
The preferred method for all communication is WhatsApp. Unless something is time-sensitive or an emergency, send a message there rather than calling.
When the grandson sends a message with multiple points or instructions, acknowledge receipt by restating each point back to him. This ensures nothing is missed.
There is a pink medical form on the refrigerator called the MOLST (Medical Orders for Life-Sustaining Treatment). If an ambulance is called and the grandson is not home, you must hand this form to the emergency responders immediately when they arrive. Do not wait to be asked for it — bring it to them right away.
The form tells the medical team about her treatment preferences. Emergency responders are trained to follow it. Keep it in mind whenever 911 is called.
She takes two daily medications: a blood thinner and a heart rhythm medication. You are responsible for administering these at the correct times. Send a photo on WhatsApp to the grandson every single time — no exceptions.
She wears a pulse oximeter ring on her finger at all times. The only exception is when washing her hands — remove it first, replace it immediately after. The ring sends live readings to her phone via the VIHealth app.
iPhone: apps.apple.com/us/app/vihealth/id1413644737
Android: play.google.com/store/apps/details?id=com.viatom.vihealth
A separate handheld pulse oximeter with two sensor attachments:
The nasal cannula has two soft prongs that insert into the nostrils. The prongs curve downward and inward, following the natural curve of the nasal passage. When correctly placed, the tips of the prongs point toward the floor of the nose — not upward, not outward, and not away from the face.
A common mistake is inserting the cannula upside down, so the prongs curve outward and upward, away from her face. If the tips are pointing toward her upper lip or angled away from her nostrils, the cannula is on wrong. Flip it so the curve follows the nose downward.
The ring reading can drop significantly during movement — even to very low numbers. This is normal and does not automatically mean something is wrong. If she is eating, being helped to move, riding in a car, or otherwise active with her hands, a low reading is likely motion artifact. Wait until she is still and relaxed before acting on it.
A reading that stays consistently low while she is clearly at rest, or that dips and recovers repeatedly over several minutes while she is still, is meaningful. A single drop during movement is not.
Move to Step 2. If she was just moving, wait until she settles and re-check.
Try the ear sensor first (either ear). If neither gives a reading, use the finger sensor.
Administer oxygen. Start at 0.5 liters per minute and increase gradually until her level stabilizes between 95 and 97.
Reduce by 0.5 liters per minute. Continue reducing in 0.5 increments until she settles between 95 and 97.
When she lies down, assume she needs oxygen. Put the oxygen on as she gets into bed without waiting for a confirmed low reading. Start at 0.5 liters per minute and adjust upward based on what the ring reads once she is settled. Target range: 95 to 97.
Normal pulse range: 60 to 90 beats per minute.
The walker must be within arm's reach of her at all times — wherever she is sitting, wherever she is sleeping, and wherever she is in the process of transitioning (standing up, sitting down, putting on shoes, moving from one room to another).
Never let the walker drift to the other side of the room. When she settles into a chair or into bed, place it directly beside her before stepping away.
The highest fall risk is during transitional moments — putting on or taking off shoes, rising from a chair, moving from bed to standing, or navigating a doorway. Position yourself to catch her during every single one of these moments.
On days when she appears especially weak, increase vigilance for the entire day — not just during obvious transitions.
When she needs to get up, encourage her to rise on her own first — she will often ask for help but should be encouraged to try anyway. If she still needs assistance, offer the minimum required. The level of help should match what she actually needs, not what she requests.
Every morning, verify the sensor pads are correctly positioned:
If a pad has shifted overnight, reposition it before she gets back into bed.
Leaving a wet or soiled brief on — even briefly — increases the risk of skin breakdown, rashes, and UTI.
Escort her to the bathroom and stay nearby at all times. For bowel movements you will need to assist with cleanup. For urination, hand her the front wipes and let her clean herself — but stay close.
There are two separate types of wipes in the bathroom:
The front and rear wipes must never be mixed up or used on the wrong area.
Always wipe front to back — never back to front. Use fresh material for each pass. Never reuse anything that has touched the anal area near the urethral area.
She has dementia and does not remember names, including the aide's. She will often call for help by saying "hey, hey, hey" or making sounds that suggest distress. This is how she calls for attention — it is not necessarily a sign of an emergency.
Be proactive: check in with her regularly without waiting for her to call out. If she does call out or make distress sounds, respond immediately and calmly.
Repeated questions are completely normal with dementia. Answer calmly and patiently every single time — do not show frustration, and do not remind her that she already asked.
Use the Live Transcribe app — it converts your spoken words into text on screen in real time. Show her the screen and she can read what you are saying.
iPhone: apps.apple.com/us/app/live-transcribe/id1471473738
Android: search 'Live Transcribe' by Google in the Play Store
Speak slowly and clearly, facing her directly at eye level in good light.
Pre-printed signs are posted around the home. Her grandson will show you basic signs. You can also use:
You will assist with dressing fully. Be patient and move at her pace. Never rush her — this is also a moment to check for any skin irritation or bruising.
She rests frequently. When she does, you are expected to rest too — especially after a demanding night. Her rest periods are your recovery time. There is no pressure to stay active or find tasks during this time.
No food that is meant to be eaten should be placed on or near the kitchen sink at any time. This is a contamination risk.
The aide must remain seated next to her at all times while at the senior center — not at a nearby table, not across the room. Right next to her.
You may notice other aides sitting apart from their clients, or staff may suggest you sit at a separate table. This is not the protocol here.
"Thank you — I understand that's the usual setup here. Our family has asked me to stay right next to her at all times. I appreciate your understanding."
Say this politely but firmly. If you go to a new or unfamiliar center, state it proactively when you arrive.
She does not like being cooped up and goes out often. You are her full caregiver on all outings. She frequently uses Uber and Lyft — check both apps for price and use whichever is cheaper. When in a vehicle, she sits in the front passenger seat.
She goes almost every day and looks forward to it. On days she is unwell, she stays home. Whenever she is up for it, going is always the right call.
On a typical night she needs the bathroom at least twice. With a UTI or another issue, it can be every hour or more. Plan for two trips and be prepared for more.
The grandson is home most of the time and gives feedback often — frequently by text, even from inside the house. Please receive it openly, not personally. He repeats things as many times as needed and has a lot of patience. He only asks that you stay receptive.
There is no obligation to continue if this role is not right for you. We only ask that you never leave mid-shift without notice. Let us know respectfully and we will part ways gracefully.
| Edad | 94 años |
| Vive con | Su nieto, quien está en casa la mayor parte del tiempo |
| Movilidad | Camina con andador — manténgase siempre cerca para prevenir caídas |
| Audición | Mayormente sorda — comuníquese con Live Transcribe, leyendo los labios o con gestos |
| Visión / Lectura | Lee perfectamente — hay letreros impresos en la casa |
| Estado cognitivo | Demencia — problemas de memoria a corto plazo; las preguntas repetidas son normales |
| Personalidad | Dulce, sociable y perceptiva emocionalmente. Puede ser resistente o ruda con alguien nuevo al principio. No es personal. Sí se calienta. La paciencia y la constancia son lo que funciona. |
Busque al nieto u otra persona responsable, pídale directamente que la cuide, y espere su confirmación antes de irse. Un "yo la tengo" verbal es el traspaso. Cualquier cosa menos no cuenta.
Nunca asuma que, porque hay muchas personas en la habitación, alguien la está vigilando. Manténgase atenta sin importar quién más esté presente.
El método preferido es WhatsApp. A menos que algo sea urgente, envíe un mensaje allí.
Cuando el nieto envíe un mensaje con varios puntos, confirme la recepción reiterando cada punto. Esto asegura que no se pase nada por alto.
Hay un formulario médico rosa en el refrigerador llamado MOLST (Órdenes Médicas para Tratamientos de Soporte Vital). Si se llama a una ambulancia y el nieto no está en casa, debe entregarle este formulario a los paramédicos de inmediato cuando lleguen. No espere a que se lo pidan — lléveselo de inmediato.
El formulario informa al equipo médico sobre sus preferencias de tratamiento. Los paramédicos están capacitados para seguirlo. Téngalo presente cada vez que se llame al 911.
Toma dos medicamentos diarios: un anticoagulante y un medicamento para el ritmo cardíaco. Envíe una foto por WhatsApp al nieto cada vez — sin excepción.
Ella lleva puesto un anillo pulsioxímetro en todo momento. La única excepción es al lavarse las manos — retírelo y vuelva a colocarlo de inmediato. El anillo envía lecturas en tiempo real mediante la app VIHealth.
iPhone: apps.apple.com/us/app/vihealth/id1413644737
Android: play.google.com/store/apps/details?id=com.viatom.vihealth
La cánula nasal tiene dos puntas suaves que se insertan en las fosas nasales. Las puntas se curvan hacia abajo y hacia adentro, siguiendo la curva natural del conducto nasal. Cuando está bien colocada, las puntas apuntan hacia el suelo de la nariz — no hacia arriba, no hacia afuera, y no alejadas de la cara.
Un error común es insertar la cánula al revés, de modo que las puntas se curvan hacia afuera y hacia arriba. Si las puntas apuntan hacia el labio superior o se alejan de las fosas nasales, la cánula está puesta al revés. Gírela para que la curva siga la nariz hacia abajo.
El anillo puede mostrar lecturas muy bajas durante el movimiento. Esto es normal. Si está comiendo, moviéndose, en un auto, o activa con las manos, espere a que esté quieta antes de actuar.
Pase al Paso 2. Si acababa de moverse, espere a que se calme.
Sensor de oreja primero. Si no da lectura, use el de dedo.
Administre oxígeno. Comience en 0.5 litros por minuto, ajuste hasta 95–97.
Reduzca 0.5 litros por minuto hasta estabilizar entre 95 y 97.
Cuando se acuesta, asuma que necesita oxígeno. Coloque el oxígeno al acostarse sin esperar una lectura confirmada. Comience en 0.5 litros y ajuste hasta 95–97.
Rango normal: 60 a 90 latidos por minuto.
El andador debe estar al alcance de su mano en todo momento — donde sea que esté sentada, durmiendo, o en proceso de transición.
Nunca deje que el andador se aleje. Cuando ella se siente o se acuesta, colóquelo directamente a su lado antes de alejarse.
El mayor riesgo de caída ocurre en los momentos de transición — ponerse o quitarse los zapatos, levantarse de una silla, pasar de la cama a estar de pie, o cruzar una puerta. Posiciónese para sostenerla en cada uno de estos momentos.
Anímela a levantarse sola primero. Si realmente necesita asistencia, ofrezca solo la mínima necesaria.
Cada mañana, verifique que las almohadillas estén bien posicionadas:
Dejar el pañal mojado o sucio aumenta el riesgo de irritación de la piel e infección urinaria.
Acompáñela al baño y permanezca cerca. Para deposiciones, usted la ayudará a limpiarse. Para orinar, entréguele las toallitas delanteras y déjela hacerlo sola.
Siempre limpie de adelante hacia atrás — nunca al revés. Use material limpio para cada pasada.
Tiene demencia y no recuerda nombres. Frecuentemente llama diciendo "hey, hey, hey" o haciendo sonidos de angustia. Así pide atención — no es necesariamente una emergencia.
Sea proactiva: revísela con regularidad sin esperar a que llame. Responda de inmediato y con calma. Las preguntas repetidas son completamente normales — responda con paciencia cada vez.
iPhone: apps.apple.com/us/app/live-transcribe/id1471473738
Android: busque 'Live Transcribe' de Google en Play Store
Hable despacio, mirándola directamente a la altura de los ojos con buena luz.
Usted la ayudará a vestirse completamente. Sea paciente, vaya a su ritmo, y aproveche el momento para revisar si hay irritación o moretones en la piel.
Descansa con frecuencia. Cuando lo hace, se espera que usted también descanse. Sus períodos de descanso son su tiempo de recuperación.
Ningún alimento destinado a ser comido debe colocarse sobre el fregadero de la cocina. Es un riesgo de contaminación.
La cuidadora debe permanecer sentada junto a ella en todo momento — no en una mesa cercana, no al otro lado del salón.
"Gracias — entiendo que esa es la norma aquí. La familia me ha pedido que permanezca junto a ella en todo momento. Agradezco su comprensión."
A ella no le gusta quedarse encerrada y sale con frecuencia. Usted es su cuidadora completa en todas las salidas. Usa Uber y Lyft — compare precios. En el vehículo, viaja en el asiento delantero.
Va casi todos los días y lo espera con gusto. Los días que no está bien, se queda en casa.
En una noche típica necesita el baño al menos dos veces. Con una infección urinaria puede ser cada hora. Planifique para dos visitas y esté preparada para más.
El nieto está en casa la mayor parte del tiempo y da retroalimentación con frecuencia. Por favor recíbalo de manera abierta, no personal.
No hay obligación de continuar si este rol no es para usted. Solo pedimos que nunca abandone el turno sin avisar.
| Age | 94 years old |
| She living with | She grandson, who does be home most of de time |
| Mobility | She does walk with a walker — always stay close so she don't fall |
| Hearing | She mostly deaf — talk to she using Live Transcribe app, lip reading, or gestures |
| Vision / Reading | She does read perfectly — printed signs post up around de house |
| Cognitive status | She have dementia — short-term memory problems; repeated questions is normal |
| Personality | She sweet, social, and she does feel yuh energy — warmth goes a long way. She might be resistant or even a lil rude toward somebody new at first. Dat ain't personal. She does warm up. Patience and consistency is what does work. |
Find de grandson or another responsible person, ask dem direct to watch she, and wait for dem to confirm before yuh leave. A verbal "I got she" is de handoff.
Never assume dat because plenty people in de room, somebody watching she. Stay attentive no matter who else deh deh.
De preferred way to communicate is WhatsApp. Unless something urgent, send a message deh.
When de grandson send a message with plenty points, acknowledge receipt by restating each point back to him. Dis make sure nothing get missed.
Dere is a pink medical form on de fridge called de MOLST (Medical Orders for Life-Sustaining Treatment). If an ambulance get called and de grandson not home, yuh must hand dis form to de emergency responders right away when dey reach. Don't wait for dem to ask — bring it to dem straight away.
De form tells de medical team about she treatment preferences. Emergency responders trained to follow it. Keep it in mind whenever 911 get called.
She does take two medications every day: a blood thinner and a heart rhythm medication. Send de grandson a photo on WhatsApp every time — no exception.
She does wear a pulse ring on she finger at all times. Only time is off is when she washing she hands — take it off, put it back on straight after. De ring sends live readings through de VIHealth app.
iPhone: apps.apple.com/us/app/vihealth/id1413644737
Android: play.google.com/store/apps/details?id=com.viatom.vihealth
De nasal cannula have two soft prongs dat go into de nostrils. De prongs does curve downward and inward, following de natural curve of de nasal passage. When it place correctly, de tips of de prongs point toward de floor of de nose — not upward, not outward, and not away from she face.
A common mistake is putting de cannula in upside down, so de prongs curve outward and upward, away from she face. If de tips pointing toward she upper lip or angling away from she nostrils, de cannula on wrong. Flip it so de curve follow de nose downward.
De ring reading does drop plenty during movement — even to very low numbers. If she eating, being help to move, in a car, or active with she hands, a low reading is likely just movement. Wait until she still and calm before yuh act on it.
Move to Step 2. If she was just moving, wait till she settle.
Try de ear sensor first. If it don't give a reading, use de finger sensor.
Give de oxygen. Start at 0.5 liters per minute and increase slowly until she settle between 95 and 97.
Dat is too high. Reduce by 0.5 liters per minute. Keep reducing until she settle between 95 and 97.
When she lie down, assume she need oxygen. Put de oxygen on when she getting into bed — don't wait for a confirmed low reading. Start at 0.5 liters per minute and adjust based on what de ring saying once she settle. Target range: 95 to 97.
Normal pulse range: 60 to 90 beats per minute.
De walker must be within arm's reach of she at all times — wherever she sitting, wherever she sleeping, and wherever she in de middle of transitioning.
Never let de walker drift to de other side of de room. When she settle into a chair or into bed, place it right beside she before yuh step away.
De highest fall risk is during transitional moments — putting on or taking off shoes, rising from a chair, moving from bed to standing, or going through a doorway. Position yuhself to catch she during every single one of dese moments.
When she need to get up, encourage she to try sheself first. If she truly need help, give only de minimum required.
Every morning, check dat de sensor pads sitting right:
Leaving a wet or soiled pamper on does increase de risk of skin problems and UTI.
Escort she to de bathroom and stay close at all times. For bowel movements yuh go help clean she. For urinating, hand she de front wipes and let she clean sheself — but stay close.
Always wipe front to back — never back to front. Use fresh material for each pass.
She have dementia and she don't remember names. She does often call for help by saying "hey, hey, hey" or making sounds like she in distress. Dat is how she does call for attention — it ain't necessarily an emergency.
Be proactive: check in with she regularly without waiting for she to call out. Respond right away and calmly. Repeated questions is completely normal — answer calm and patient every single time.
iPhone: apps.apple.com/us/app/live-transcribe/id1471473738
Android: search 'Live Transcribe' by Google in de Play Store
Speak slow and clear, face she directly at she eye level with good light.
Yuh go help she dress fully. Be patient and go at she pace. Don't rush she — dis is also a moment to check for any skin irritation or bruising.
She does rest plenty. When she rest, yuh must rest too — especially after a hard night. She rest time is yuh recovery time.
No food dat's meant to be eaten should go on or near de kitchen sink. Dat is a contamination risk.
Yuh must stay seated right next to she at de senior centre at all times — not at a nearby table, not across de room.
"Thank you — I understand dat's how it usually does go here. De family ask me to stay right beside she at all times. I appreciate yuh understanding."
Say it polite but firm. If yuh go to a new centre, say dis proactively when yuh reach.
She don't like staying inside too long and does go out plenty. Yuh is she full caregiver on all outings. She does take Uber and Lyft — check both apps for price and use de cheaper one. In de vehicle, she does sit in de front passenger seat.
She does go almost every day and she does look forward to it. Days she not well, she stays home.
On a typical night she does need de bathroom at least twice. With a UTI it could be every hour or more. Plan for two trips and be ready for more.
De grandson does be home most of de time and does give feedback often. Please take it with an open mind — don't take it personal.
No obligation to continue if dis role ain't right for yuh. We only ask dat yuh never leave mid-shift without saying something.