Posts Tagged ‘Caregiver’

Could Your Family Benefit From Family Therapy?

Tuesday, July 29th, 2014

Conflicts can arise when a family member has Alzheimer’s. Carole Larkin, a geriatric care manager in the Dallas area, says that 30% of her family clients experience conflict. And she says that is doubled for blended families. Most conflict centers around what type of care should be provided to the person with Alzheimer’s. Other arguments typically involve money and facility placement.

According to an article on the Mayo Clinic website, family therapy is “a type of psychological counseling done to help family members improve communication and resolve conflicts.”

The Mayo Clinic article states, “Family therapy can be useful in any family situation that causes stress, grief, anger or conflict.” Having a family member with Alzheimer’s usually causes all of those.

The article continues, “It can help you and your family members understand one another better and bring you closer together. Family therapy sessions can teach you skills to deepen family connections and get through stressful times, even after you’re done going to therapy sessions.”

Conflict is to be expected even in the best of families, and this can increase if one member has a serious disease, such as Alzheimer’s, that requires extensive caregiving.

So how do you know if professional counseling could be needed for your family? I would suggest you consider it if at least one family member’s mental health and daily functioning are being seriously affected by the strife.

Another sign – and an important one – that outside help is needed would be if the constant bickering is negatively impacting the quality of care being provided to the person with Alzheimer’s.

What If Some Family Members Refuse to Participate? Don’t be surprised if some family members flat out refuse to take part. And don’t be surprised if it’s the one(s) considered by others to be the source of much of the conflict.

You might try having their primary care provider, clergy person, or lawyer speak to them about it. Sometimes people pay more attention to someone outside the family.

If they still refuse, the other family members can go ahead without them. The therapy may still be helpful to the ones who do go, and it may help them better cope with the one who won’t attend the sessions.

Could a Therapist Help You? When to Consider Getting Professional Help

Friday, July 25th, 2014

Some Indications You Might Benefit From Seeing a Therapist: There are several situations in which people can benefit from therapy. Two important ones for Alzheimer’s caregivers are:  When you feel overwhelmed by your stress or  when you are seriously depressed.

Let’s look at each of these in a little more detail.

Stress: The Alzheimer’s Association lists the following as symptoms of caregiver stress:

  1. Denial
  2. Anger
  3. Social withdrawal
  4. Anxiety
  5. Depression
  6. Exhaustion
  7. Sleeplessness
  8. Irritability
  9. Lack of concentration
  10. Health problems

Depression: Some of the symptoms of depression are the same as those for stress. The Alzheimer’s Association lists the following symptoms of depression:

  1. Becoming easily agitated or frustrated
  2. Feelings of worthlessness or guilt
  3. Feelings of hopelessness
  4. Thought of death, dying or suicide
  5. Disturbed sleep
  6. Fatigue or loss of energy
  7. Loss of interest or pleasure in usual activities
  8. Difficulty thinking or concentrating
  9. Changes in appetite or weight
  10. Physical symptoms that do not respond to treatment, such as headaches, digestive disorders and pain.

Everyone knows that Alzheimer’s caregiving is almost always stressful and depressing. Virtually EVERY caregiver has more than one of the above symptoms. So how do you know if you could benefit from professional help? I would suggest you consider it whenever you have one or more of the above symptoms, they are significantly interfering with your daily life, and nothing else has helped (such as a support group, group therapy, respite care, pastoral counseling, etc.)

Some Examples of Specific Ways a Therapist Can Help You: Therapists can help people in many ways. Three important ones for Alzheimer’s caregivers are:

  1. Help you overcome your denial and come to terms with your situation
  2. Help you manage your depression better (if you are depressed)
  3. Help you improve your stress management techniques


How You Can Help Someone Who Is an Alzheimer’s Caregiver

Monday, July 21st, 2014

According to the Alzheimer’s Association, 15 million people are serving as caregivers to people with Alzheimer’s, providing over 1.7 billion hours of unpaid care every year. Carrying out their duties has a negative effect on their physical and mental health.

With so many people being Alzheimer’s caregivers, chances are good that you know one – either a friend, relative or neighbor. And chances are that you’d like to help, but simply don’t know how.

If you really want to be of service, instead of just saying, “Let me know if there’s anything I can do,” you may need to figure it out yourself and volunteer for a specific task(s).

Here are but a few things you can select from:

  1. Help clean the house
  2. Take over extras from a meal you’ve cooked for your family
  3. Do the laundry
  4. Do the grocery shopping
  5. Pick up medicines from the pharmacy
  6. Volunteer to run other specific errands
  7. Mow the lawn and/or do other yard work (assuming the person doesn’t use a lawn service)
  8. Visit and just let the person talk about feelings
  9. Drive the person with Alzheimer’s to their daycare center (if they’re going to daycare)
  10. Take the person with Alzheimer’s to the doctor
  11. Take the person with Alzheimer’s out for a drive
  12. Look after the person with Alzheimer’s in your home for a few hours

Whatever you select, try to be specific and try to volunteer to do it on an ongoing basis. Make sure you will be able to continue your help before you make a commitment.



When You Become the Parent to Your Parent

Sunday, July 20th, 2014

People who have Alzheimer’s disease gradually lose the ability to manage their own affairs. When this happens you will need to step in and help out. In effect, you become the parent.

The amount of parenting needed depends in part on the person’s living arrangement. A parent living with your or with a spouse who can help them or a parent living in an assisted living or long-term care facility where a considerable amount of help is provided will need less assistance than a parent living alone.

But regardless of where your mother or father lives, you will still probably have to function as a parent in many ways, and your specific duties will expand and increase considerably as the illness progresses.

10 Important Responsibilities

There are numerous tasks and responsibilities you will have to assume or at least help out with. 10 important ones are:

  1. Do laundry for them
  2. Clean their home
  3. Do their grocery shopping and other errands
  4. Prepare their meals
  5. Purchase their medicine and remind them to take it
  6. Get them to stop driving when or if appropriate
  7. Arrange for entertainment and engage them in meaningful activities
  8. Provide social stimulation by having them spend time with friends, relatives and/or neighbors
  9. Handle their financial and legal affairs
  10. Make health care decisions on their behalf

Some of these duties will be more difficult than others to carry out. Typically, getting someone to stop driving and/or arranging for placement in a facility if they don’t want to move are the most stressful and challenging to achieve.

In these cases you will need to provide “tough love” – much as they may have shown you when you were an adolescent. You will have to be guided by your determination of what is best for them and then go forward with no hesitation, regardless of their desires and oft-stated objections. This will not be easy, but it has to be done. You will have to assume the role of parent and be firm in order to prevail for their benefit.





10 Things People With Alzheimer’s Taught Me

Wednesday, July 16th, 2014

I was a caregiver for Ed, my beloved Romanian life partner, for seven years when he had Alzheimer’s disease. Furthermore, I currently volunteer to make weekly visits to four women who live at Clare Bridge, a Brookdale Senior Living memory care facility in Overland Park, Kansas. (I refer to them as “my ladies.”) Here are the ten most important lessons these people have taught me.

  1. Simple pleasures can bring great joy to a person with Alzheimer’s
  1. People with Alzheimer’s usually enjoy getting gifts – no matter how small
  1. Pets, children, music and art may reach them on levels we cannot
  1. Just because they don’t talk doesn’t mean they aren’t perfectly aware of what’s going on around them and what people are saying to and about them
  1. There’s usually no reason to tell them someone is dead (Tell them a white lie instead – that the person will be back soon)
  1. Correcting them about something will probably either embarrass them or else start a big argument
  1. People with Alzheimer’s usually adjust to change more quickly than we do and they soon forget unpleasant things that happen to them. We may be the ones who continue suffering
  1. They can still enjoy life, even if only for brief periods of time
  1. People with Alzheimer’s may remember past love and also experience love in the present
  1. People with Alzheimer’s can be humorous at times – Then we can laugh with them.


Moving on After the Death of a Loved One With Alzheimer’s

Saturday, July 12th, 2014

Grief must be fully experienced before you can move on. You need to allow yourself time to grieve. It’s important to take good care of yourself physically and emotionally during this time. It will also help to realize that with time your pain will lessen and you will be able to move on.

At some point – when you feel you’re ready – try to begin “returning to the world.” Take up a new hobby or go back to one that lapsed while you were caring for your loved one. Spend more time with the family members and friends you may have seen less in the preceding months or years. Some people also benefit from doing volunteer work.

Much to my surprise, one day I suddenly realized that I’d completely forgotten the third anniversary of Ed’s death a month earlier. That’s when I knew my grief was largely resolved.


Caregiving May Be Wrecking Your Health

Wednesday, July 2nd, 2014

What many Alzheimer’s caregivers don’t realize is that carrying out their duties may be creating chronic stress, which can lead to a significant decline in physical and mental health.

Alzheimer’s caregivers typically fail to pay attention to their own health. They may fail to fill prescriptions, they state they have not gone to the doctor as often as they should.

Caregivers have an increased number of emergency room visits and use of all types of health services. Furthermore, “caregivers have an increase ($4,766 per year) in healthcare costs associated with their caregiving.

Not surprisingly, caring for someone with dementia is particularly challenging, causing more severe negative health effects than other types of caregiving.

Mental Health Effects of Caregiving

When compared to their non-caregiving counterparts, family caregivers report highler levels of stress/distress, depression, emotional problems, and cognitive problems. Between 40 – 70 percent of caregivers have clinically significant symptoms of depression. This depression is not only significant in iitself, it can lead to physicial problems as well.

Physical Health Effects of Caregiving

Physical ailments common to caregivers include chronic pain such as headaches and backaches, and weakened immune systems.

Other problems include chronic conditions (including heart attack/heart disease, cancer, diabeter and arthritis). Also, Alzheimer’s caregivers have increased rates of physical ailments (including acid reflux, headaches, and pain/aching), increased tendency to develop serious illness, and high levels of obesity and bodily pain. Another physical ailment is a diminished immune response, which leads to frequent infection and increased risk of cancers.

Finally, strained caregivers have a 63 percent greater chance of death within 4 years as compared to non-caregivers.

My next blog post will focus on what caregivers can do to protect their physical and mental health from all of these illnesses.



Entertaining People With Alzheimer’s – The Simpler, the Better

Sunday, June 29th, 2014

Simple pleasures can indeed bring great joy to people living with Alzheimer’s. Often the activities can be based on something that brought pleasure to the person before getting Alzheimer’s. Here’s a little story that can serve as an example.

When I went to visit Ed one day, I realized I’d forgotten to bring any ‘props’ for the visit. Usually I brought something to amuse Ed such as a new stuffed animal, a book with colorful pictures, some of my photographs, a CD with classical music or something like that.

Those things engaged his mind, to the extent that was still possible, and gave us a focal point for interacting.

Suddenly I realized I was wearing a coat with numerous pockets I was sure he would love to explore. I thought the fact that he enjoyed exploring pockets and compartments in clothing, purses or brief cases so much was somehow related to his life-long fixation on ‘luggages’ and his love of exploring all their different compartments.

He spent 30 minutes gleefully exploring all the pockets in the coat. Then he smiled at me and told me twice how happy he was that I had such a wonderful coat. I was touched that that wonderful demented man was happy for me.

That was so typical of Ed. Instead of saying how happy he was to play with the coat, he said how happy he was that I had it. As I left I felt loved. I also felt deeply gratified I’d been able to bring him so much happiness with a simple coat. Just a simple coat with a few pockets.


When Your Grief Never Ends

Thursday, June 26th, 2014

Coping with loss is an ultimately deeply personal and singular experience. The best thing you can do is to allow yourself to feel the grief as it comes over you. Resisting it will only prolong the natural process of healing.

According to the Center for Complicated Grief, for most people, grief never completely goes away but recedes into the background. When grief does not lessen with time, the result is what is called “complicated grief.”

The Mayo Clinic, says that “While normal grief symptoms gradually start to fade over a few months, those of complicated grief linger or get worse. Complicated grief is like being in a chronic, heightened state of mourning. In complicated grief painful emotions are so long lasting and severe that you have trouble accepting the loss and resuming your own life.”

The article lists the following symptoms of complicated grief:

  • Extreme focus on the loss and reminders of the loved one
  • Intense longing or pining for the deceased
  • Problems accepting the death
  • Numbness or detachment
  • Preoccupation with your sorrow
  • Bitterness about your loss
  • Inability to enjoy life
  • Depression or deep sadness
  • Trouble carrying out normal routines
  • Withdrawing from social activities
  • Feeling that life holds no meaning or purpose
  • Irritability or agitation
  • Lack of trust in others

One of the primary differences between normal grief and complicated grief is that the latter does not recede into the background with time. It consistently interferes with daily life and the eventual ability to move on.

If you suspect you may have complicated grief, it would be wise to seek professional help.


Take Your Loved Ones to a Doctor When They’re Showing Signs of Alzheimer’s

Monday, June 23rd, 2014

Unfortunately, in many cases people experiencing symptoms of Alzheimer’s flat out refuse to consult a doctor.

You may be able to reason with those who have mild symptoms, although it may take several discussions before they agree to be seen. You might also ask a good friend or favorite relative to speak with the person. Sometimes people will pay more attention to someone other than the primary caregiver. You could also ask the person’s physician or attorney to talk with them about it.

The Alzheimer’s Association St. Louis Chapter suggests that you seize the opportunity. Suggest a check-up if your loved one expresses any concern about ‘not remembering things lately.’ You could explain that there are new medications that may help with memory, but they must be prescribed by a doctor.

Another piece of advice is to ask them to see the doctor as a favor to you. At times, loved ones will do something for others that they would not do for themselves.

Those with more advanced symptoms may not be amenable to a logical discussion. You may have to use what we call ‘therapeutic fibbing.’ For example, tell the person you have a doctor’s appointment and ask them to go with you. This of course would have to be prearranged so the physician would know the real reason for the visit.

Finally, as a last resort, the St. Louis Alzheimer’s Association chapter says you may have to call Protective Services. If your loved one has become a danger to themselves, or if their well-being in in jeopardy, outside help might be required.