Dementia insights: Advice for caring for someone in mental decline
The Alzheimer‘s Association estimates 5.4 million American are living with Alzheimer‘s disease, a number that is expected to escalate rapidly as the baby-boom generation reaches retirement age. The number of people caring for someone with dementia is substantial, and growing, as well.
Upstate geriatrician Andrea Berg, MD, has something to say about four issues that are bound to come up in the course of caregiving:
Never correct; just redirect.
Reflexive as it may be to correct something a loved one says that is incorrect, Berg and other geriatricians caution against it.
“When you correct somebody, it throws them on their heels and makes them lose their confidence a little bit more. Typically people are already self conscious about losing memory and to some degree aware of memory problems in the earlier stages of the disease."
“In the moderate to advanced stages, people can perseverate on a concept such as ‘I want to go home‘ even if they might be in their home. They‘re referencing a different time because their time frame is skewed. Instead of correcting them, which is usually a futile effort, focus on the concept of home and engage them on what is appealing about being home. In acknowledging and validating the emotional content of what is being said, you often can drive the conversation into a different direction -- as opposed to creating conflict if you try to correct them.”
Eating should be pleasurable.
Beyond providing sustenance, “eating should remain one of those primal pleasurable activities,” Berg says. “I caution people to not get hung up on the details or place undue dietary restrictions on their loved one. In the late stages, if they want to eat ice cream three times a day, go for it. This isn‘t the time to be overly concerned about watching your salt or sugar.”
Eating is likely to become more challenging as the disease progresses. Berg is a proponent of hand feeding.
“It doesn‘t have to be fast. Go slow,” she advises. “Meal time could be a positive interaction between a loved one and their caregiver, a way to care for somebody and show love, so that it‘s not just nutritional nourishment but also a social support.”
They don‘t wander -- until they do.
It‘s not an early hallmark of the disease, but as it progresses, Berg says people with dementia may wander and become lost, without warning.
“It‘s something that should be on your radar, especially for people who are functionally independent and can walk around on their own,” she says.
Berg directs caregivers to Safe Return, a 24-hour nationwide emergency response service provided by MedicAlert and the Alzheimer‘s Association.
Caring for yourself is a must.
Often caregivers will say they don‘t have time to take a yoga class or walk around the block, or anything else that would allow them to recharge.
“Rates of depression and anxiety and overall poor health outcomes are rampant in caregivers of loved ones with dementia,” Berg points out. “You have to maintain your own level of health, or else you‘re not going to be much help to those for whom you care.”
That includes paying attention to nutrition, getting adequate sleep, going to your own doctor appointments, exercising and taking time for yourself. It also includes allowing others to help and taking people up on offers to sit, cook, clean or run errands. Knowing you are not alone can be a huge stress reliever. “It‘s not selfish,” she says. “It‘s necessary.”
This article appears in the fall 2016 issue of Upstate Health magazine. Click here for a radio/podcast interview with Berg. For another interview on Alzheimer's disease, click here.