Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver can handle it. Long-term, help is needed. Outside help at this point is needed.
A typical pattern with an overloaded caregiver may unfold as follows:
- 1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
- 20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
- 38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.
It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.
With the holiday season upon us, caregivers feel even more stress -- with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help. Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.
An article in “Today’s Caregiver” states:
“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”
It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or areverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times -- the family is experiencing it for the first time.
An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.
If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needs, both physically and mentally. Seek out professional help that will ease your burden and look for community service organizations that offer respite help.
The National Care Planning Council’s website www.longtermcarelink.net contains hundreds of articles with tips and advice for caregivers and their families. Take a few minutes to find the help you need and enjoy this holiday season.
The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.
Though the family was disappointed over the cake, of more concern was Grandma’s confusion with the recipe and her similar confusion about the loved ones around her. Could something be wrong with grandma's mental state?
One might say that for an elder person a little forgetfulness or confusion is normal, but when do you know if there is a serious problem, such as dementia?
An online article from FamilyDoctor.org outlines some common symptoms in recognizing dementia.
"Dementia causes many problems for the person who has it and for the person's family. Many of the problems are caused by memory loss. Some common symptoms of dementia are listed below. Not everyone who has dementia will experience all of these symptoms.
- Recent memory loss. All of us forget things for a while and then remember them later. People who have dementia often forget things, but they never remember them. They might ask you the same question over and over, each time forgetting that you've already given them the answer. They won't even remember that they already asked the question.
- Difficulty performing familiar tasks. People who have dementia might cook a meal but forget to serve it. They might even forget that they cooked it.
Problems with language. People who have dementia may forget simple words or use the wrong words. This makes it hard to understand what they want.
- Time and place disorientation. People who have dementia may get lost on their own street. They may forget how they got to a certain place and how to get back home.
Poor judgment. Even a person who doesn't have dementia might get distracted. But people who have dementia can forget simple things, like forgetting to put on a coat before going out in cold weather.
- Problems with abstract thinking. Anybody might have trouble balancing a checkbook, but people who have dementia may forget what the numbers are and what has to be done with them.
- Misplacing things. People who have dementia may put things in the wrong places. They might put an iron in the freezer or a wristwatch in the sugar bowl. Then they can't find these things later.
- Changes in mood. Everyone is moody at times, but people who have dementia may have fast mood swings, going from calm to tears to anger in a few minutes.
Personality changes. People who have dementia may have drastic changes in personality. They might become irritable, suspicious or fearful.
- Loss of initiative. People who have dementia may become passive. They might not want to go places or see other people."
Dementia is caused by change or destruction of brain cells. Often this change is a result of small strokes or blockage of blood cells, severe hypothyroidism or Alzheimer’s disease. There is a continuous decline in ability to perform normal daily activities. Personal care including dressing, bathing, preparing meals and even eating a meal eventually becomes impossible.
What can family members do if they suspect dementia? An appointment with the doctor or geriatric clinic is the first step to take. Depending on the cause and severity of the problem there are some medications that may help slow the process. Your doctor may recommend a care facility that specializes in dementia and Alzheimer’s. These facilities offer a variety of care options from day care with stimulating activities to part or full-time live-in options. Sometimes if patients tend to wander off, a locked facility is needed.
In the beginning family members find part time caregivers for their loved one. At first, loved ones need only a little help with remembering to do daily activities or prepare meals. As dementia progresses, caregiving demands often progress to 24 hour care. Night and day become confused and normal routines of sleeping, eating and functioning become more difficult for the patient. The demented person feels frustrated and may lash out in anger or fear. It is not uncommon for a child or spouse giving the care to quickly become overwhelmed and discouraged.
Family gatherings provide an excellent opportunity to discuss caregiving plans and whole family support. It is most helpful if everyone in the family is united in supporting a family caregiver in some meaningful way.
"The first step to holding a family meeting, and perhaps the most difficult one, is to get all interested persons together in one place at one time. If it's a family gathering, perhaps a birthday, an anniversary or another special event could be used as a way to get all to meet. Or maybe even a special dinner might be an incentive.
The end of the meeting should consist of asking everyone present to make his or her commitment to support the plan. This might just simply be moral support and agreement to abide by the provisions or it is hoped that those attending will volunteer to do something constructive. This might mean commitments to providing care, transportation, financial support, making legal arrangements or some other tangible support." The Four Steps of Long Term Care Planning
Professional home care services are an option to help families in the home. These providers are trained and skilled to help with dementia patients. Don’t forget care facilities as well. It may be the best loving care a family member can give is to place their loved one in a facility where that person is safely monitored and cared for.
The National Care Planning Council supports caregiving services throughout the country.
By Senior Daily Living
As we age, we naturally have difficulty remembering things or finding the right words to say. This is normal. However, Dementia is not normal. The condition causes mental changes that make it difficult to function and carry out our normal lives, not just remember names and dates.
Dementia causes a decline in mental functioning, particularly memory, which makes what was once a simple task into an impossible challenge. There is difficulty finding the right words, and confusion sets in when there are too many tasks at once. There can be a change in personality that leads to aggression, paranoia, inappropriate or bizarre behavior, or depression.
Dementia in the elderly can take on two different forms; reversible and chronic. When symptoms are reversible, the short-term dementia has been caused by other illnesses or diseases. The National Institute on Aging has classified 100 conditions that can cause short-term dementia. These are often called "pseudodementias", and are treatable. Some examples include:
Adverse reactions to Medications- Side effects mimicking dementia are most commonly caused by antiarthritic medications, anihypertensizes, neuroleptics, hypnotics, and sedatives. Make sure your doctor is monitoring all your medications, including over-the-counter.
Emotional Distress- Seniors face a tremendous amount of changes in their lives, sometimes abrupt. Retirement, loss of a loved one or pet, divorce, change in location; all of these can cause depression, anxiety, and can damage physical and mental health. Make sure your physician is informed of these stressors in your life.
Metabolic Disturbances- Electrolyte imbalances, hypoglycemia, hypercalcemia, hepatic diseases, pancreatic disorders, renal failure, or liver failure can also cause confusion and effect sleep, appetite, and emotional balance.
Hearing and Vision- Problems with sight and hearing can be misinterpreted as Dementia when a person loses the ability to fully perceive their surroundings as they used to. Perform hearing and eye examinations if this seems to be the case.
Nutritional Imbalances- Deficiencies of niacin, folate, thiamine, or riboflavin can create impairment of cognition. Clear markers of this include difficulty swallowing, chewing, or digesting food. Loss of the ability to smell, taste, or eat due to dentures or trouble shopping can all contribute to nutritional deficiencies.
Other possible causes of acute dementia include: Endocrine abnormalities, infections, Subdural Hematoma (blood clotting on the brain's surface), brain tumors, and Atherosclerosis (hardening of the arteries).
There are also conditions that cause permanent cognitive dysfunction. They include: head traumas, Cerebral Degenerative Diseases like Alzheimer's, Parkinson's, and Huntington's chorea.
Full medical and neuro-phychological testing is needed to diagnose dementia. CAT scans and MRI's are usually part of this process. Also the newer PET scans and SPECT scans, which are harder to find. These processes will find whatever may be a treatable cause of acute dementia.
Chronic and irreversible dementia requires special care, however. This usually comes in the form of Behavior management techniques, safety precautions within the home, and legal considerations like durable power of attorney. Care is often provided in the home, but in some instances special arrangements need to be made for out of home care.
Caring for a loved one with Alzheimer's can be overwhelming. Families are often faced with the decision of whether to care for a loved one at home or to choose a nursing home or assisted living facility. A caregiver can provide personal care and relief in the form of respite care that assists families in coping with Alzheimer care and management. Home care assistance can allow your loved one to remain at home in familiar and comfortable surroundings and to function as independently as possible.
Many Massachusetts residents in need of Alzheimer care can remain in their homes longer with the assistance of CareTrak Home Care. Our caregivers are trained and experienced in Alzheimer care. They can provide personal care, companionship, safety supervision, meal preparation, medical reminders and respite/relief.
Contact the Alzheimer's Association for additional information about this disease.