Are you currently involved in or soon to be a caregiver for an aging parent or family member with dementia or Alzheimer’s Disease?
If you are not yet one, but anticipate that you will be, then now is the time to start preparing yourself for the challenge. According to statistics offered by the National Institute on Aging (part of the National Institute of Health) in the fall of 2009, there were over ten million caregivers in the United States involved in providing care to dementia and Alzheimer’s Disease patients.
Success as a caregiver and the ability to manage the stress that it generates demands that certain skills be present or developed. I am relatively new to caregiving, having become a practitioner since 2004 with members of our own family. In these six years, I have found that there are seven crucial skills or foundation attributes that are common among thousands of successful caregivers.
1. Patience.
As a caregiver your best laid daily plans for your patient or loved one will not always survive the end of any given day. At times, those best laid plans of yours for Mom, Dad, Grandpa, or non-family member crash and burn right at the start of your day or care shift. Why? Several reasons.
First, because their illness and the physical pain and discomfort that accompany it act as a major distraction to staying on task or following what you are asking or expecting them to do. Second, because your patient no longer possesses the same sense of urgency to accomplish a task as you do. Third, because they may not also be able to move as fast as they used to. (Rheumatoid Arthritis may be present too). Cognitively, they may now easily loose track of not only what you are encouraging them to do, but how to do it as well. Dementia may be present, and, like battery acid, can corrode away the cognitive battery terminals. Self-awareness fades from the scene.
Contending with all of these distractions requires that you adapt to a new set of coping skills,and, to frequently draw from a freshly dug deep well of patience.
Before becoming a caregiver to members of my family, I had prided myself as a successful business supervisor: having disciplined myself over many years to be punctual or early, to multitask and work both efficiently and productively, and stay with a task or project until done. The words, tenacious, driven, possesses a strong sense of urgency, often appeared in my annual performance reviews'. I was known as the driving guy that “attacked” my work or special assignments and was known for delivering results.
So for me, early on, I felt like a revved up, tire smoking NASCAR racer trying to navigate through a pedestrian mall chock full of shoppers with no where to go and all day to do it. I was piloting the wrong kind of vehicle for the obstacle course at hand. Time for an adaptive change up before I drove myself nuts and my stress level went through the ceiling. Slowing down and scaling down my expectations and goals to better match the pace of my family member was a hard challenge, but one that I eventually became competent at. It took me all of two years to make the kind of transition I felt good about. At least my tenacious quality served me get me to this level.
Now, my proverbial well to draw patience from has been deepened from a shallow six-footer to three hundred foot plus! A modest reserve of patience is now in place for those drought days.
2. Rhinoceros Skin or Medieval Armor.
As our seniors grow older their daily concerns seems to shrink down to the following “hit-parade” of just six topics: bowels, bladder, canes, medications, doctors, and walkers. Basic concerns of grooming, appearance, housekeeping, and hygiene seem to no longer be on the radar. As a caregiver, your efforts at persuading, assisting, guiding, cleaning and tidying up with these concerns will often provoke and annoy your patient to sudden outbursts or accusations.
Some of the more popular ones go like: “Where did you put my pills,” or, “I can’t find my cane." " Where in hell did you hide it?", or, “Why do you always rearrange my stuff?, now I cannot find a damn thing!” Still more defiant remarks can sound like these: “This is my damned house, not yours, stop trying to move everything around and confuse me!”, or, “Stop bossing me around, just go home and leave me the hell alone!”
Since neither rhinoceros hide jackets nor a complete suit of medieval armor are available at your local “caregiver supply store”, you must compensate and “armor up” yourself in a different manner.
Remind yourself each day before beginning your caregiver assignment: my patient or family member is ill and hurting, they don’t mean to be hurtful towards me and what I do for them.
Remind yourself each day that the decline or absence in former good judgment and reasoned out choices on the part of the patient is not willful and has nothing to do with any attempt to piss you off or get under your skin. Your patient does not wake up every day with the singular notion of how they can upset or belittle you.
You must find a way to get comfortable with not hearing a lot of thank-you responses. The old saying is true: “People tend to take for granted the services of those that they count on the most.” Your good work as a caregiver IS NOTICED by your patient. The problem is just that their declining cognitive skills interfere with more frequent and mindful notice by them of all that you do each week.
3. A good sense of humor.
Find a way to laugh at yourself. Find a way to see some of the humor in what comes up in your daily care of your patient or family member. The humor that you find in what happens with them is not to serve as a means for belittling or mocking the symptoms of a disease that they did not ask to befall them. A good laugh or two, shared each day with your patient, serves to lighten up both their stress and yours.
I find humor in the multitude of places that canes are tossed, thrown, or left behind. I find humor in the many locations that a mishandled pill, tablet or capsule winds up.
I find humor in discovering that a pair of cucumbers were placed in a lingerie drawer or that a camisole was folded carefully then placed in the vegetable crisper.
I find humor even when I discover that the walker or wheelchair I am putting away had fresh dog crap smeared along one of the wheels, and is now smeared within the palm of one of my hands.
4. Positive attitude.
The glass is half full, not half empty. Bad times, just like the storms or heat waves Mother Nature sends us, do not last forever.
The struggles your patient is having in getting dressed today, or perhaps remembering to take their medications will not necessarily be the same problems that arise tomorrow. There will be other problems that pop up, but not always the same ones. Take them in stride.
So what if Mom insists on wearing the same pantsuit outfit every time she goes in for a doctor’s visit! So what if a family member always insists on rummaging through her purse every time she rides in your car with you! Stay positive. As long as their content and relaxed, each of these incidents are really just small matters.
5. A willingness to learn,
Investigate and keep up to date on the medical condition your patient has been diagnosed with. Call it a little child’s curiosity. Medical science, particularly microbiology, cell science, genetics and nanotechnology are progressing at a staggering pace. New medications and drug therapies are being developed and written about every day. It is encouraging and uplifting to follow what is coming in the future. There are many medical information web sites that you can subscribe to for free and receive daily or weekly e-mail updates of the most recent discoveries and drug trials.
6. A channel for your frustrations.
Whether your hobby is gardening, crocheting, going to bingo, crocheting, bicycling, ballroom dancing, painting, crossword puzzles, mud wrestling, photography, an hour at the shooting range, or even a couple of fun hours on Facebook with friends, children and family members. It doesn’t matter what the hobby is as long as you can derive both an enjoyment out of it and an escape into it.
I am fortunate in that I enjoy the multiple hobbies of gardening, carpentry, and now blogging and writing about the challenges and rewards of caregiving.
Your hobby will act as a counterbalance to the stress of caring for a family member or another patient.
7. Prepare to be adaptive.
The behaviors and demands of your patient will change over time rather than remain constant. You will need to anticipate this and be ready to adapt and adjust your approach when you notice a change. You don’t have to like change but you do have to realize that it will happen and be ready for it. It is a mindset change of shifting from reactive (response to an event after the fact) to pre-active (a game plan in place before the event occurs).
I had to change my own problem-solving approach from the use of a professional 30’’ loggers chain saw to that of a manual coping saw. A change of situation called for a change in the skill tools I was employing. Still cutting problems down to size, but with less speed and frenzy. My adaptive caregiving pace could now be described as much slower but proceeding with steady diligence. Fingernail clippers work nicely for grooming one’s nails whereas a gas powered hedge trimmer would cause a bit of a stir. Find the right fit, the right skill and the right tool. It took me awhile, but I did it.
Jeff Dodson is a Alzheimer’s/Dementia caregiver
and caregiver advocate who lives and writes out of Elk Grove, California.
He is reachable on MySpace and Facebook and can be e-mailed at:
www.imaginatic@frontier.com, or, visit his Blog at www.nvlwtrdodson.blogspot.com
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