Zero-Waste Eldercare- Part 1: Defining the Problem

On Christmas Eve, 2014, our precious dog, Lainie, developed a life-threatening intestinal blockage thanks to her ingestion of a soiled Depends left in a location she could easily access. An overnight stay with IV fluids and medications at the emergency animal hospital saved her life without surgery. Lainie made an amazing recovery once the blockage was cleared and we are so happy to have her back with us.

However, we are not happy about the enormous vet bills and remain concerned about a possible repeat of the event in the future. These concerns are a catalyst for completing the transition to a zero-waste lifestyle that I started several years ago. Eliminating garbage in my home will eliminate some of the attraction animals have to its smelly contents. Only problem is, the zero-waste concept seems to be an oxymoron when it comes to eldercare.

I’ve been slowly working in easy changes over several years to zero-waste such as reusable bags, bulk groceries, recycled toilet paper, and signing up for no preference service to eliminate junk mail. Seattle has a great city-provided recycling and compost program, and partners with a number of recyclers in our area. But, the complete elimination of all trash has eluded me at this point as our culture has a now deeply-rooted disposable products mentality. I’ve decided that a Zero-Waste New Year’s Resolution seems like an interesting and worthwhile challenge.

Eldercare and Increased Garbage

When Dad moved in with us, our garbage production sky-rocketed from one bag per month to 2-3 bags per week. We had gotten ourselves down to one bag of trash a month by pre-cycling, recycling, and using reusable items instead of disposable. I was then able to downsize our trash can to the micro-can size provided by Seattle Utilities, and saved money on our bill. We were on the road to completely eliminating all trash from our home and with it the cost of city trash disposal. However, Dad’s arrival reversed that trend.

Like many Americans, including myself at one point, Dad is accustomed to using disposable tissues rather than handkerchiefs to blow his nose, creating one source of increased garbage immediately. Dad tends to only use a small part of the center section of the tissue before disposal. Combined with his constant nasal drip problem, he uses 1-2 boxes of tissues every week, or 52-110 boxes per year. Even with purchasing 100% recycled tissues, this was a considerable source of new waste in our home. And, Lainie has decided that shredding soiled tissues all over the floor is nearly as satisfying as eating soiled Depends.

Another source of increased waste was the purchase of pre-packaged food items. Dad has a deep and enduring love for snack foods as evidenced by the 10 pounds he gained in the first 6 months he lived with us. Additionally, trekking Dad around to his doctors’ appointments and social events meant that he and I were frequently far from home. Traffic, long appointment wait times, and other delays meant that I packed snacks before outings with Dad. Potato chips, corn chips, and energy bars are all packaged in non-recyclable packaging, and eliminating them from Dad’s diet to save his waistline, and our pocketbook and micro trash can, led to considerable and ongoing conflict. To a person accustomed to eating snack foods, a sliced apple with peanut butter just isn’t appealing. Dad’s dementia has further complicated this problem because he isn’t capable of making the connection between consumption of snack foods and health problems; as with children, we are simply left to eliminate the snack foods and ignore his complaints.

Along with snack foods, Dad’s Meals on Wheels also generate a small amount of trash. Each cardboard meal tray comes with a plastic cover that must be disposed of in the trash. The trays themselves are compostable so this is not a serious problem, but the plastic covers always have a little food stuck to them. Lainie is of course very interested in the kitchen trash as a source of interesting new gastric delicacies so we have to be vigilant about keeping the cupboard door closed. I considered canceling the Meals on Wheels, but the program has been such a huge benefit to our family that it outweighs the plastic covers.

Other new sources of trash occurred in smaller quantities: baby wipes, cough drop wrappers, Q-tips, plastic drinking straws, disposable gloves, etc.

But, the biggest new source of trash in our home was Dad’s soiled incontinence products, which are all disposable plastic and adsorbent materials. Each week, we empty one 20-gallon trash bag of soiled incontinence products from Dad’s bathroom and send it to the landfill. To add insult to injury, disposable adult incontinence products are expensive. Dad uses about 5 pairs of Depends per day at a cost of $0.50 per pair. Over the course of a year this adds up to over $900 per year on underwear alone! An elderly person’s medical expenses can eat up half their income, and this added expense of incontinence products can be a significant financial hardship.

Addressing these challenges in the Zero-Waste Eldercare context requires more retooling of our lives than most people attempting Zero-Waste because there isn’t much information available. So, next I need to dig around.


When Pets and the Elderly Go Wrong, or How to Avoid the Problem We Had

We spent a lovely afternoon and evening with family on Christmas Eve. There was plenty of entertaining conversation, excellent food, and a free dance and song performance compliments of my niece. As we were loading the car with leftovers and preparing to leave, it seemed that a perfect evening was coming to a close and we would head home to a warm house, and our sweet 12 year old dog, Lainie.

Lainie is an affectionate girl, and a source of comfort to “Grandpa”, my father. Pets fulfill an important role in relieving loneliness in the elderly. Lainie benefits by getting extra treats from Grandpa, and accompanies us on “Grandpa walks” during clement weather.

Things started to go awry when Dad ventured out of the house unaccompanied. I was loading the car and anticipated that I would return to fetch Dad and help him navigate the walkway out to the car. Only Dad decided to reclaim his independence and in the process missed a step and fell. Luckily, his only injury appears to have been a scraped knee. However, it took my husband and brother-in-law to get him onto his feet and back into the house. We then checked Dad out for injuries and patched up his knee.

After we recovered from Dad’s fall, we headed home. We arrived home without incident and got Dad into the house and unloaded the car. Lainie greeted us at the front door, ecstatically wagging her tail and making her usual “I’m so happy you’re home” noises, which are somewhere between a cry and a howl. All seemed well until I went into Dad’s room to prepare him for bed.

A former stray, Lainie suffers from occasional bouts of separation anxiety which manifest as destructive chewing events. Unknown to me, Dad had placed more than just tissues into his bedroom waste can. A large can with a fitted lid resides in the bathroom for soiled undergarments, but Dad’s decreasing mobility meant that he disposed of a few undergarments in his bedroom waste can. Depends contain an odor neutralizer that can fool my nose but not a dog’s. Several pairs of soiled Depends lay in shreds on the floor, their contents spread over the carpeting. It also appeared that Lainie had eaten the Depends, and then vomited it up the material in a corner in the room. I sighed and then cleaned up the mess.

I soon discovered 2 more vomiting episodes, one on an upholstered chair and another on Lainie’s bed. It was at that point that I realized we were going to need to get her medical care. It was 11pm on Christmas Eve. The only vet open at that time was the after-hours emergency clinic on the other side of town.

I let Dad know he could call us if he had a problem, because we couldn’t fit everyone in the car and leave room for Lainie to be sick. I urged Dad to not wait up for us, because depending on what type of care Lainie needed, we might not be home until the wee hours of the morning. I kept my fingers crossed that Dad wouldn’t have any problems because there was no one to call at that hour to hang with him while we were gone.

The emergency vet clinic was not busy and they took Lainie back for exam immediately. The vet returned to report that an x-ray showed more material was in the stomach, and that Lainie might be able to clear the rest of the Depends naturally with some special care at home. We paid the large bill and went home. By then, it was around 1:30am.

However, Lainie’s condition degraded during the day and we were forced to return to the animal hospital early Christmas evening. Lainie then spent the night at the hospital on IV fluids and anti-emetics. We were greatly fortunate that the vets were able to clear her intestinal blockage without surgery. We paid an even larger bill and took and took a tired, but overjoyed dog home on the evening of the 26th.

For follow-up home care, we followed the vet’s special feeding instructions: every 4 hours for 48 hours with a high fiber canned food. Meals were closely followed by walks as the food was designed to quickly move through Lainie’s system and clear the remainder of the adsorbent material out of her body. Lainie recovered quickly and without incident.

Although it would have been better if we had had the foresight to prevent Lainie’s bowel obstruction from occurring in the first place, we were extremely fortunate that we live in a time and place where such excellent medical care is available for animals. It wasn’t the best Christmas I have ever had, but it had a happy ending.

Here are my tips from the experience for those people with pets and elderly parents at home:

  • Keep the door to your parents’ bedroom and bathroom closed.
  • Double check that the door to your parent’s room is closed before leaving for an outing.
  • Don’t allow pets into your parent’s room.
  • Ensure that all trash cans have a fitted lid. Even if you think they should only be used for non-toxic items, a parent with mobility problems or dementia may put any number of items in the trash.
  • Consider confining a pet to a room/crate that does not contain chew hazards if the pet is prone to separation anxiety. Or leave the pet at a daycare/sitter.
  • Keep a healthy emergency fund to cover unanticipated expenses.

Dad gets a Wheelchair

Despite having had all his pills on time, Dad was having so much difficulty walking at lunch the other day that I ordered an ultralight-weight folding portable wheelchair off of to use when we go places with him. The wheelchair weighs about 20 lbs., light enough that I can get it into the trunk of the car alone. Without a wheelchair that light, it would require 2 people to get Dad to doctors’ appointments and social events, not a very feasible situation most of the time.

Once a PD patient reaches their maximum medication dosages, there isn’t much more that can be done other than to try to maintain the patient’s current status. Basic movements such as walking, bending, and balance become very difficult. The constant or near constant tremors and effort required to perform basic tasks cause PD patients to become easily fatigued. Even though tremors are involuntary, they still consume energy. Imagine moving constantly during waking hours and never resting, it would be exhausting. This is the point we are now at.

I have looked at used medical supply stores, but they don’t seem to carry the type of wheelchair I was in the market for. Besides the light weight and foldability of the chair, it also has a nice set of hand grip brakes, seatbelt, and foot rests. It retailed for about $150 on Amazon. Despite the cost, I think we need the chair or resign ourselves to being house-bound most of the time. This is not a happy thought, especially during the holidays.

Medicare and insurance companies will only pay for extra-heavy duty non-portable wheelchairs that even my husband cannot lift. Thus we are left with the choice of purchasing a portable wheelchair at our own cost. Forgoing such an expenditure would create a living situation so challenging that it would be nearly unbearable.  Such out-of-pocket expenditures are partly what contribute to the $5000 or so per year that the average American family spends on eldercare.

Dad and I have stood in the rain for 15 minute stretches at the base of our street-to-house stairs while he gathers up the willpower and energy to climb them. Sadly, not only is there not enough room around our home to build a wheelchair ramp (a contractor took measurements and declared it impossible already), but Medicare will not pay for a wheelchair ramp because it could be used by people other than the intended recipient. Of course this rationale is completely ridiculous because someone other than the intended recipient could use a wheelchair at times also. This leaves families with room around their homes to install ramps at their own cost, or they may qualify for assistance with some programs.

Thus, we progress into a new stage of PD and learn to cope with the changes.

Macadamia Nut French Toast Recipe

Yesterday, when I was grocery shopping, I noticed that macadamia nuts and sourdough bread were on sale. I bought them despite the fact that I had no idea how I was going to prepare them at the time. I was sure I could come up with a tasty plan though.

I’ve been making an effort lately when grocery shopping to buy food that is on the day-old bread rack or listed as “Manager’s Special”. These food items are typically close to out-dating and may be thrown away by the grocery store due to public safety concerns if not purchased by shoppers. Food waste in the US is staggering, by some estimates 40% of all food produced is sent to the landfill. Far less than 40% of our population is facing serious food insecurity, meaning that if we prevented food waste through better distribution of our food supplies, we would not have a hunger problem in the US.

I realized that one way average people like us can reduce food waste is to simply purchase food that is close to out-dating, bring it home, cook it, and eat it as part of our normal diet. Of course, this requires some creativity in the kitchen because the nearly outdated ingredients may be somewhat random, like macadamia nuts and sourdough bread. Or potatoes and eggplant. Or lamb and yogurt. But, there are so many recipes available now in cookbooks and on the Internet that virtually any combination of ingredients can be made into a meal.

If you are accustomed to shopping with a list for a weeks’ menu plan, you can accommodate the spontaneity of purchasing nearly outdated food by having a “Manager’s Special” spot in your menu plan at the beginning of your week. Cooking your Manager’s Special food soon after purchase will help prevent spoilage, and you can relish the creative masterpiece that your parsimony has brought you.

For Sunday brunch at home, today’s Manager’s Special recipe ending up being Macadamia Nut French Toast. Because of the various dietary restrictions in our house, this recipe is egg-less, cholesterol-free, lactose-free, and sugar-free. The recipe can be made gluten-free by substituting the sourdough bread with a gluten-free variety.

The recipe was surprisingly light despite the macadamia nuts. Because the batter was egg-less, it was safe to give the last little bit remaining to our dog, Lainie, who had staged a lie-down food protest in the middle of the kitchen floor after she smelt the toast cooking. It was impossible to leave the kitchen without stepping over her and meeting her manipulative starving-puppy “If you really loved me, you’d share your food with me” gaze.

⅓C Soy powder

2C coconut milk

½ C macadamia nuts, ground fine in a food processor

1t vanilla extract

1t ground cinnamon

½ t ground nutmeg

2T cornstarch

1 day-old loaf sliced sourdough bread

Mix soy powder, coconut milk, vanilla and spices together until smooth. Stir in macadamia nuts. Dip bread into mixture until coated evenly with batter and macadamia nuts. Pan-fry in a small amount of vegetable oil over medium heat. Enjoy with sugar-free syrup, or real maple syrup.

Frugal Eldercare Part 4: Holiday Fun on the Cheap

Once or twice a month, we take a break from our usual weekend chores and have “family day”, an affordable afternoon outing with Dad that includes lunch or dinner. Last weekend, we decided we wanted to get out and enjoy some of the Christmas cheer. Dad isn’t very mobile these days and he tires easily, requiring that whatever outing we chose come with places to rest.

Because it was raining and a bit windy, we settled on an indoor activity rather than something outdoors like the Zoo Lights. We headed downtown to Pacific Place, an upscale mall in the heart of downtown Seattle. While we aren’t avid shoppers, Pacific Place has some nice restaurants, conveniently placed benches, live holiday music, and a collection of nutcrackers decorated by local artists.

Normally, we park in the lot underneath Pacific Place which has ample disabled parking and nice elevators. However, this time the lot was full and we chanced parking in an old building across the street. The building we parked in must have been built in the early part of the 20th century and then converted to a garage because many of the parking places were so small that we couldn’t fit our tiny Prius c in them.

The other major drawback to the building was the lack of an elevator. Instead, there was a very steep staircase that Dad had difficulty getting down. We had parked on the 4th floor, and were wondering how we were going to get Dad down all those steps despite his trooper mentality. Luckily, we met a nice, middle-aged lady coming up the stairs to return to her car. She saw Dad and offered to give him a ride down, saying that she was picking up her disabled friend at the base of the stairs. Usually, my husband and I wouldn’t  consider accepting a ride from a stranger, but we felt that it would probably be fine as there was only one way out of the building, and she wasn’t giving off any bad vibes. It would be impossible for her to drive off with Dad without us intercepting her at the bottom. True to her word, we saw her friend waiting at the bottom, and a few minutes later, Dad was dropped off with no fuss or bother. Thank goodness for the kindness of strangers!

We then headed across the street to the mall. The side walk was very sloped and Dad and I had to walk with arms linked so he wouldn’t lose his balance. But, we made it safely inside, and took the 2 elevators required to get upstairs to the dining floor. We had lunch at a Mexican restaurant which we often eat at when downtown to see a movie a few times a year. The restaurant has a nice selection of meals and can accommodate a variety of dietary restrictions. The shopping season was in full swing, so the restaurant was very busy, and hence very slow. But, we found seating at a table in the bar and were able to spend time chatting and trying to guess which international soccer teams were playing.

After our meal, we walked around the mall and looked at the nutcrackers, commenting on which ones we liked and why. The mall sponsors a nutcracker decorating project every year, and there is quite a bit of variety. The artwork goes up for sale at the end of the holiday season. Dad and I liked the nutcracker we are posed with in the photo accompanying this article. The artist had tiled her nutcracker with surplus tiles and the effect was beautiful.

We missed the last of the live music, and the next performance wasn’t for 2 hours, so we took the sky bridge over to Nordstrom to return a couple of items that did not fit. Nordstrom was also very busy and decked out for the holidays. After a few minutes there Dad felt tired so we headed home.

Elderly Outing Tips:

  • Choose activities that take into consideration: weather, proximity to parking, rest areas, and bathrooms
  • Research parking options before travel
  • Look for family restrooms in venues
  • Limit the length of the activity to your parent’s energy levels
  • Choose activities that are close to home and can be cut short easily if needed
  • Bring a picnic lunch or find restaurants that can accommodate dietary restrictions
  • Ask venues if they rent wheelchairs to visitors

Project 333: The Results of “Life is short, wear a dress!” experiment

Project 333 was a helpful examination of my lifestyle and shopping habits. I got a lot of compliments on my dresses, and enjoyed wearing them. Most of my dresses had languished in the back of my closet for years despite the fact that I really liked them and they fit well. The experiment helped me examine why this was the case and take steps to make better use of my garments.

The Reorg

First, to get dressed for a date with my husband required sorting through several drawers and a closet to find everything I needed. With my time constraints and lack of patience with the process, I simply didn’t bother to get dressed up. I used to store my clothes by garment type and color in my closet and dresser. While this type of organization allows us to store a maximum amount of clothing, we lose whole outfits in the process. I realized that separating my outfits was the crux of my problem. So, I started hanging my outfits together on hanging dress forms, including accessories. My shoes went below.

I also utilized the Japanese KonMari method of organizing, which requires that we retain only items that make us happy. By the end of this thorough process, I realized that I never wanted to purchase anything again unless I really, really needed it. Search for “The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing” by Marie Kondo if  interested.

I also hadn’t worn some garments recently because they required repair or alteration. My local dry cleaner replaced some spent elastic on a slip. My local cobbler fixed 4 pairs of shoes for less than the price of one new pair. A local department store and designer I tend to shop with also offer repair services for very reasonable fees. Handbag manufacturers are another avenue for maintaining our accessories. These services will save large sums of money and items from landfills by specializing in maintenance. Additionally, in light of the recent Great Recession, using repair services helps people stay employed, strengthening the economy without harming the financial well-being of the average person.

Future Directions:

The average American owns approximately 365 pieces of clothing, not necessarily including accessories. My total wardrobe, including clothing, shoes, and accessories is about 120 items, less than half the average.  However, the retrofitted closets in my 100-year old house are small, and my accumulation feels gargantuan. My wardrobe is very functional overall, but I have a few extraneous items I will continue to wear for financial reasons, but not replace when worn.

The result of the experiment is that I realized that I need 3 classic outfits per season, and a few accessories. I also decided with my family life that white garments are not for me. In a smaller wardrobe, garments are in more frequent rotation, so I can’t afford to have my clothes spend a lot of time in the laundry. In addition to stain-resilient colors, having clothes that can be easily repaired and upcycled to other uses makes more sense economically and environmentally than garments which become outdated or fall apart after wearing only a few times.

I plan to add pants back into my outfits now, but keep a dress on rotation. My outfits for the coming Seattle winter season, December through February, are:

Outfit # Clothes Accessories/shoes
1 Turtleneck, jeans, sweater, trench coat/down jacket Scarf, rain boots, hat, gloves
2 Silk shirt, slacks, sweater, trench coat/wool coat Necklace, flats, hat, gloves
3 Basic dress, sweater, trench coat/wool coat Scarf/necklace, rain boots, hat, gloves


Transitioning my wardrobe and shopping habits required the kind of mental reprogramming that an experiment like Project 333 and the KonMari method accomplishes. The experiment emphasized that caring for good quality, classic garments pays for itself in the long run in multiple ways; it is a healthy response to solving some of our current problems of debt, garbage, and human misery.

Finally, here are some tips from my Project 333 experiment:

  • A classic dress will give you a top and bottom for a better price than separates.
  • Dresses are more forgiving than pants if your weight fluctuates regularly.
  • Alter a garment you otherwise like if it fits incorrectly or the hemline is dated.
  • Check with your clothing manufacturer or department store, for mending and repair services.
  • Buy the best quality garments you can afford and mend them as needed to save money long term.
  • Don’t buy or keep anything in your closet that doesn’t make you happy because you won’t wear it.
  • Organize your wardrobe to best suit your lifestyle.

Clothing Care & Repair Resources:

Textile recycling resources:

Minimalist Clothing Lesson Learned: Dressing the Elderly

Very early this morning, Dad called me to ask for help. He had had a bad bout of incontinence and his pajamas and bedding were soiled. This necessitated a change in underwear, pajamas, and bed linens and a quick trip to the laundry room at an ungodly hour. When Dad starts off the day like this, it is a sign that the remainder of the day is likely to be similar.

We are currently changing some of Dad’s medications around to meet the progression of his Parkinson’s disease and the result is more side effects of some drugs and fewer beneficial effects of others. Parkinson’s disease is known as a moving target disease because the patient’s condition is constantly changing. Although the overall progression of the illness is down, patients will experience up days and down days for reasons currently unknown. Physicians respond to the situation by trying to find a happy medium that will mitigate the effects of the down days without dampening the up days too much.

Being the caregiver of a Parkinson’s patient, or any elderly person for that matter, requires a great deal of flexibility and spontaneous problem solving. One chore that is a frequent problem for caregivers to tackle is incontinence, which can occur anytime, anywhere with varying severity. On a bad day, a caregiver may help change their parent’s underwear 5 or more times, making removing and putting clothing back on complicated and time-consuming. Clothing may also become soiled, requiring quick changes.

Despite these challenges, there are some things that caregivers can do to make dressing easier on themselves and their parents. Here are some things I have learned:

  • Prevent incontinence in the first place by having parents visit the toilet at regular intervals and before outings with family. Due to memory loss and dementia, the elderly may not logically connect feeling “the urge” with needing to make a trip to the bathroom. Or they may not think to visit the bathroom until it is too late to prevent incontinence. The elderly move slowly and will also need more time to get to the bathroom.

  • Dress your parent in clothing with a minimum of fasteners. The more buttons, laces, and zippers on clothing, the more time it will take to dress and undress your parent.
  • For relaxing at home, encourage men to wear t-shirts and sweat pants. For ladies, look for nice lounge wear. These can double as pajamas and exercise wear.
  • For street clothes, look for mock turtlenecks or polo shirts, and elastic-waist chinos for men. For ladies, try elastic waist slacks or skirts, and blouses that pull on over the head.
  • Dress your parent in separates. Avoid one-piece clothing like jumpsuits, and dresses since these will complicate clothing changes and create more soiled laundry. The one exception to this is a bathrobe since it ties and easily comes off.
  • Look for warm socks with rubber tread on the bottom that can function both as socks and slippers at home. The socks provided in hospitals to patients are great because they prevent falls due to slipping.
  • Use suspenders for men’s pants instead of belts because the pants will be easier to remove when changing.
  • Look for shoes that slip on or fasten easily with Velcro. Avoid shoes with laces unless a physician directs the parent to wear lace shoes for proper foot care.
  • Try slippers with a rubber non-skid sole that are appropriate for both indoor and outdoor use.
  • Look for shoes that can be washed easily in a washing machine. Based on personal experience, I do not recommend leather shoes, unless they are washable leather, because thoroughly cleaning soiled leather shoes is terribly difficult.
  • Look for multi-functional clothing. Don’t worry about changing outfits frequently for fashion reasons as soiled clothes will need to be changed regularly anyway. Any time caregivers can cut down on clothing changes it will be easier for both the caregiver and parent.
  • Choose fabrics that wash easily in a washing machine and do not require ironing or dry cleaning.
  • Carry a “man bag” or “lady’s bag” on outings that contain several pairs of Depends, baby wipes, disposable gloves, hand sanitizer, apron for the caregiver, a plastic bag for soiled garments, and a change of clothing. Include a clean pair of socks and shoes with the change of clothing.