Dementia Care失智照顧

Alzheimer’s Care Series—Caregiver Motivation

Caregiver Stress Management

‘I do not have time to care for myself.’ If you have said this, you may be putting yourself at risk. A caregiver for a person with Alzheimer’s devotes great amounts of time and energy to the person and may experience many stressful moments, some severe. Caregivers often overlook their own needs and can become the hidden or second victims of Alzheimer’s disease.

Ten Signs of Caregiver Stress

Too much stress harms both caregiver and care recipient. When several of these signs occur often or together, they may lead to serious health problems. Recognizing your own stress and caring for yourself can make you a more effective caregiver.

Denial: denying the illness and its effect—‘I know Mother will get better.’

Anger: anger toward the person, the lack of an effective cure or other people’s lack of understanding—‘If he asks the same question one more time, I will scream.’

Social withdrawal: no longer seeing friends or doing formerly enjoyable activities—‘I no longer like getting together with the neighbors.’

Anxiety: worrying about the next day and the future—‘What happens when the care he needs exceeds what I can provide?’

Depression: loss of morale and ability to cope—‘I do not care anymore.’

Exhaustion: being too tired to complete necessary daily work—‘I am too tired to do this.’

Sleeplessness: endless worry—‘What if she wanders outside or falls and is injured?’

Irritability: moodiness and negative reactions—‘Leave me alone.’

Lack of concentration: familiar tasks become unusually difficult—‘I was so busy that I forgot our appointment.’

Health problems: emotional or physical harm—‘I cannot remember the last time I felt well.’ If several signs occur regularly, see a physician and take steps to manage stress.

Ten Ways to Reduce Caregiver Stress

Obtain an early diagnosis. Symptoms may emerge slowly, and unusual behavior may be overlooked when someone appears physically healthy. See a physician promptly when warning signs appear. Some causes of dementia symptoms can be treated. Knowing what you face helps you manage the present and plan for the future.

Learn what resources are available. Become familiar with community resources for yourself and the person you support. Adult day health centers, home-care agencies, visiting nurses and meal-delivery services may help. A local Alzheimer’s Association chapter was recommended as a starting point.

Become an informed caregiver. Different skills are needed as disease progresses. Education and practical suggestions can help caregivers understand and manage difficult behavior and personality changes.

Ask for help. Doing everything alone leads to exhaustion. Support from relatives, friends and community resources can make a great difference. Ask directly, have someone speak for you if asking is difficult, and seek professional help when stress becomes overwhelming. Support groups and helplines can provide comfort.

Care for yourself. Caregivers often devote themselves completely to another person and neglect their own needs. Pay attention to nutrition and exercise and get adequate rest. Use respite care to shop, see a film or meet friends. The people close to you—including the person with Alzheimer’s—would want you to care for yourself.

Monitor stress. Stress may cause blurred vision, stomach problems or high blood pressure and may produce irritability, poor concentration or loss of appetite. Note your symptoms, use relaxation methods that help you and consult a physician.

Accept change. Needs change as Alzheimer’s progresses and may exceed what can be provided at home. Investigating care options in advance can make transitions easier. Accept support from family and friends.

Make legal and financial plans. Consult an attorney about durable powers of attorney, advance directives, family trusts, future healthcare, housing and other important issues. Planning now can reduce later stress. When possible, include the person with Alzheimer’s and other family members.

Recognize reality. It may be hard to see the effect of your effort, but your care makes an important difference. Neither you nor the person can control many situations and behaviors. Allow yourself to grieve losses while valuing positive moments and good memories.

Give yourself credit instead of guilt. You are human. You may lose patience and may not always provide everything you wish you could. Remember that you are doing your best. Your presence beside the person you love is something of which to be proud.

The original article states that one in ten American adults had a relative with Alzheimer’s; that 70 percent of four million people with the disease were cared for at home; and that 80 percent of caregivers experienced high stress, with nearly half experiencing depression. It describes the Alzheimer’s Association as a national voluntary organization founded by family caregivers in 1980, with 200 chapters, supporting research and providing information and assistance. Its archived helpline number is (800) 660-1993.

Action Series: Three Steps for Understanding Difficult Behavior

Alzheimer’s can cause varied or unpredictable behavior. A person may become anxious or impulsive or repeat a question or action. Such changes can create frustration and tension between the person and caregiver. Remember that the person is not doing this deliberately.

Possible causes include physical discomfort such as illness or medication effects; too much stimulation from noise or a confusing environment; unfamiliar surroundings; difficulty with an activity or household task; and inability to communicate effectively. Identify the problem and consider possible solutions.

Step one—identify and examine the behavior. What is the behavior? Is it harmful? What happened immediately before it, and what may have triggered it? What happened afterward, and how did you respond? Ask what, where, when, why and how.

Step two—look for possible solutions. What does the person need, and are those needs met? Could changing the environment reduce the behavior? Could you change your own response and answer in a calm, supportive way?

Step three—try a response and review it. Choose a practical approach, observe what changes, and adapt. Every person with Alzheimer’s is different, so families and caregivers may handle the same difficulty differently.

Repetition, Suspicion and Anxiety

A person may repeatedly do or say something, repeat a word or question, pace, or undo something just completed. Often the person is seeking comfort, security or something familiar. The behavior may not harm the person but can burden the caregiver.

Memory loss may cause a person to understand events differently, become suspicious of people nearby or misunderstand what is seen or heard. Remember that the disease has impaired memory, but the person can still feel your support and understanding.

A person may become anxious, restless, need to walk, feel uncomfortable in a place, focus on small details or depend heavily on the caregiver’s attention and direction. Respond calmly, reduce unnecessary stimulation, look for discomfort or unmet needs, and obtain professional help when safety is at risk.

Adapted on the original site from Alzheimer’s Association materials. Historical helpline: 1-(800) 660-1993.