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Caregiving for
Alzheimer's Patients: Is there a
problem?
By Paul Susic MA
Licensed Psychologist Ph.D Candidate
As found in the April, 2005 Senior Circuit
Stress
in various forms may be found among the caregivers of individuals with
dementia. Many caregivers attempt to keep their loved ones at home
for a significant period of time prior to placement in a long-term
care facility. While this is admirable, it frequently also takes a
toll on the person with the primary caregiving responsibility. Some
studies have found that as many as 50% of caregivers of individuals
with dementia may be clinically depressed and in need of treatment.
High rates of caregiver burden (which is another term for the stress
which is unique to the caregiving situation) are very common, with
most caregivers being distressed by the disruptive memory and behavior
problems that are typical to dementia
patients (e.g. repetitive
questioning, incontinence, night-time wandering) and frequently report
needing help to cope with these daily challenges. Researchers
have found that the combination of the physical demands of caregiving,
plus the psychological distress involved, put caregivers at risk for
developing their own significant health problems. For example, it is a
well-known fact that caregivers are less likely to engage in
preventative health behaviors (e.g. regular checkups), and some
evidence an increased dysregulation of stress hormones (such as
cortisol) and/or compromised immune system functioning, with either
potentially leading to serious health problems over time. One
major study found that stressed spousal caregivers were far more
likely to die within a four year period of time when compared to
non-stressed spousal caregivers or to those of non-caregivers, versus
those of a similar age and socioeconomic level.
The most typical caregiver of a relative with Alzheimer's disease or
other forms of dementia (e.g. stroke related, or due to late-stage
Parkinson's disease) is a middle-aged woman caring for one or both of
her parents (or in-laws). She is usually married, with teenage
children and employed outside of the home. The next largest group of
caregivers is the wives of the demented individuals, who are usually
over 70 themselves.
How can I relieve the
stress of this burden?
The first thing that you can do is to realize that you do not have to
do it alone. You should first seek the help of family members, church
members or other supportive individuals to help or to least to allow
you to take a break on occasion. Also, pay particular attention to
self-care including eating right, taking time for exercise, sleeping
as well as possible and getting regular physical checkups. It is
important to understand that the physical status of the long-term
caregiver may need to be assessed periodically, since the combination
of long-term stress and limited self-care usually takes its toll on
the physical health of the individual involved.
As with most circumstances in life, education is always important.
Education related to specific disorders can usually be found by
searching your local library, in the Yellow Pages or on the Internet.
Organizations such as the Alzheimer's Association provide
opportunities for education as well as support groups for individuals
sharing these same experiences.
Traditionally, caregivers have been referred to support groups for
treatment in spite of their high-level of distress, due to the fact
that they do not generally see themselves as ”patients" or "clients"
needing help; rather they focus their attention on obtaining help for
their spouse or loved one. The Alzheimer's Association provides the
largest number self-help groups for demented caregivers, with chapters
all over the United States. They frequently have psychoeducational
components along with support groups. There are no fees involved and
you usually do not have to sign up for a specific number of sessions.
However, a recent study compared support groups with a more structured
skill building psychoeducational program and found the latter to be
significantly better for improving mood, enhancing coping strategies
and developing an improved ability to obtain additional help with the
caregiving responsibility. Other studies comparing structured
programming with support groups found similar results in teaching
caregivers a variety of skills to better handle their negative
emotions, the disruptive behaviors of their loved ones and becoming
more empowered to cope effectively with this chronic stressful
situation.
At the very least, take care of yourself, learn as much as you can
about the related disorder, get some help and respite whenever
necessary, get proper medical and mental-health assistance, and
finally, ultimately recognize your limitations when you can no longer
handle your loved one at home.
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