Are you so committed to caregiving tasks that you’ve neglected your own physical, mental, and emotional well-being? The following questions may help you determine if you are putting your health at risk:
Do you visit your doctor annually?
The best thing you can do for the person with Alzheimer’s disease is to stay healthy. Respect what your body is telling you. Take exhaustion, stress, sleeplessness and changes in your appetite or behaviour seriously. Ignoring these symptoms can cause your physical and mental health to decline.
Do you accept assistance from others?
You can’t do everything. Attempting to handle everything yourself will only lead to burnout, depression and resentment toward the person you care for. You are not failing as a caregiver by asking others for help. When friends and family offer help, accept it. Also look into community resources that offer respite from caregiving responsibilities.
Do you talk to others about your feelings?
You may think that no one understands what you are going through. Holding in your feelings, however, will only make you feel isolated and emotionally neglected. Sharing your experiences with others may help you put things into perspective.
- There are six simple steps you can take to ensure that you are a healthy caregiver:
- See your doctor regularly.
- Get screened for stress and depression.
- Get plenty of rest.
- Eat well-balanced meals.
- Exercise regularly.
- Accept help from others.
More than 80 percent of Alzheimer’s caregivers report that they frequently experience high levels of stress, and nearly half say they suffer from depression. Many caregivers don’t recognise their needs, fail to do anything about them, or simply don’t know where to turn for help. Too much stress can be damaging to caregivers and the person with Alzheimer’s. Recognising the signs and learning how to reduce stress can help.
Warning signs of caregiver stress
- Social withdrawal
- Lack of concentration
- Health problems
If you are a caregiver who regularly experiences several of these stress symptoms, consult a doctor.
Ways to reduce caregiver stress
- Know what resources are available in your community
- Become educated about Alzheimer’s disease and caregiving techniques
- Get help from family, friends and community resources
- Take care of yourself by watching your diet, exercising, and getting plenty of rest
- Manage your level of stress by consulting a doctor and using relaxation techniques
- Accept changes as they occur
- Engage in legal and financial planning
- Be realistic about what you can do
- Give yourself credit for what you have accomplished; don’t feel guilty if you lose patience or can’t do everything on your own
Depression is four times more likely to strike those over age 65 than younger individuals. It is found in 20 percent of persons with Alzheimer’s disease, in up to 50 percent of Alzheimer’s caregivers, and in 15 percent of adults over age 65. Sadly, most people never get help for this treatable illness.
Symptoms of depression
The presence of at least four of the following symptoms over a two-week period may indicate depression:
- Depressed or irritable mood
- Feelings of worthlessness, self-reproach, or excessive guilt
- Suicidal thinking or attempts
- Motor retardation or agitation
- Disturbed sleep
- Fatigue and loss of energy
- Loss of interest or pleasure in usual activities
- Difficulty thinking or concentrating
- Changes in appetite and weight
Source: American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders
Indicators of depression in caregivers
Stress, anger, guilt, and grief related to caregiving can lead to depression.
Caregivers can experience grief at any point in the disease process. You should seek help if the grieving process is so prolonged that it affects both physical and mental well-being.
Treatment is available
If symptoms of depression are present, it is important for you to obtain a complete medical evaluation to rule out other causes. Medications or an unrecognised disorder may cause depression.
If there are no other underlying causes, consult a psychiatrist to obtain a diagnosis. Geriatric psychiatrists specialise in recognising and treating depression in older adults.
There is no one test to identify depression. The diagnosis involves assessment of medical history, possibly interviews with family members, and a mental status examination.
Treatment for depression can include some combination of medicine, therapy, psychosocial support and activities.
If you are a family caregiver, you can expect to experience feelings of loss, especially as your life and the person you love are changed by Alzheimer’s disease. The natural phases of grieving usually involve denial, anger, guilt, physical symptoms, and eventually acceptance. It is important to know, however, that everyone grieves differently.
Symptoms of grief
- Denial that your loved one is ill
- Periods of helplessness, despair and depression
- Changes in appetite or sleep patterns
- Feelings of anger or frustration with the person with Alzheimer’s and with caregiving tasks
- Withdrawal from social activities, friends, family and the person you care for
Throughout the process of grieving and mourning, guilt is often the most prevalent feeling for caregivers.
Guilt can be related to:
- Thinking you could have done something differently
- Being able to enjoy life while your loved one may not
- Feelings that you have failed, especially if your loved one has been placed in a nursing home
- Negative thoughts about the person with the disease — wishing that his or her suffering would come to an end
- Conflicts with family members because they are uninvolved or critical of the care that’s being provided
In many cases, feelings of guilt are linked to unrealistic expectations. To cope with the grieving process, try taking the following steps:
- Confront your feelings
- Accept guilt as a normal part of loss and grief
- Find ways to forgive yourself
- Share your feelings with a friend, support group, therapist or spiritual leader
- Learn to feel comfortable accepting and celebrating good things in your life
If grieving is so prolonged or severe that your physical and mental well-being are at risk, seek help from your doctor. There are ways that you can begin to cope with grief, including:
- Returning to some aspects of your daily routine
- Allowing time for physical exercise, play and rest
- Trying to find humour, even in difficult situations
- Bringing balance to your life by doing things that you enjoy
- Preparing for what the future may entail
Children and teens
Alzheimer’s disease has a large impact on family life. It is important to take the time to talk to the children and teens in your family so they understand what is happening to the person with Alzheimer’s.
The degree to which children and teens are affected by the disease depends on who has the disease — a parent or grandparent, relative or friend. Other factors include how close the child or teen is to the person and where the person lives (in the same home, nursing facility, another province or country).
Feelings and reactions
Children and teens may feel:
- Sad about changes in a loved one’s personality and behaviour
- Confused about how people get the disease and why the person behaves differently
- Afraid of the way the person behaves
- Worried that they or their parents might develop the disease
- Angry and frustrated by the need to repeat activities or questions
- Guilty for getting angry or being short-tempered with the person
- Jealous and resentful because of the increased amount of time and attention that is given to the person with Alzheimer’s
- Embarrassed to have friends or other visitors to the house
Children and teens can react in ways you may not easily recognise. They may:
- Complain of vague physical complaints, such as a stomach ache or headache
- Perform poorly at school
- Spend more time away from home
- Stop inviting friends to the house
Ways to help children and teens cope
- Maintain open lines of communication
- Offer comfort and support
- Provide opportunities for them to express their feelings
- Let them know their feelings are normal
- Educate them about the disease and encourage them to ask questions
- Respond honestly to questions
Activities that can help and be done as a family
- Go for a walk
- Do household chores together, such as folding laundry, cooking or gardening
- Listen to music, dance or sing
- Look at old photographs
- Read a favourite book or newspaper
- Develop a memory book about the person
- Make a family tree
- Watch a film
- Keep a diary