Having spent my career as a Medical Social Worker and Elder Abuse Investigator it seems natural for me to share some insight for those family members and caregivers working with victims of Alzheimers disease. I will not take a Physiological and Psychological approach for delivering information. I will leave that to Physicians and Therapists. What I would like to share is some practical information that has proven helpful to my clients and their families and caregivers. First of all, I will say that being with a loved one or patient with Alzheimers type dementia is difficult if not heartbreaking. Seeing a person often familiar or most dear in an abyss of memory loss takes determination and strength. The greatest barrier to appropriate care is accepting the relationship must change and must become flexible. It is the burden of the caregiver to initiate these changes in order to provide safe and loving care. The nature of this illness fluctuates and the direct caregiver would benefit from being able to do the same, emotionally and practically. Visualize the mind of the patient or loved one as a window. The window is often foggy, half open, closed or completely clear. There is no timetable that will report what is going on inside the window. The foggy window represents the normal goings on with the early or mid-stage person with Alzheimers. The half-open state is the obvious fluctuations between clarity and confusion. It is during this phase that most agitation, suspicion, aggression and fear are displayed. This is the most difficult time for the caregiver and the most emotionally painful for the person being cared for. The closed or end-stage is the most painful for the caregiver. The person behind the window is no longer home and often recognizes no one or nothing around him or her. Activity in the affected brain is erratic and therefore there are often periods of clarity, comprehension with appropriate behaviors and responses. Knowing how to respond to these changes can reduce the burden of care, increase the safety of the cared for and bring some peace of mind and acceptance for the caregiver. In my next article I will address some basic strategies for coping with and managing the phases described above. 2006 Sherry Mahi |
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