Caregiving

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    A Neurology, answered on behalf of
    As a caregiver, you may need an antidepressant if you’re very depressed. See your physician or mental healthcare professional or ask yourself some simple questions:
    • Do you feel sad?
    • Do you feel angry?
    • Do you feel anxious?
    • Do you feel depressed?
    • Is your function suffering, meaning you can't do things you'd like to do, not because of your caregiving but simply because you don't have the energy or desire, or you're too sad?
    • Do you find yourself crying?
    • Do you find yourself having suicidal thoughts? If you do, you should absolutely see a healthcare professional.
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    A Neurology, answered on behalf of
    The best way to know if you need to get help as a caregiver for someone with dementia is to ask yourself how you feel. Do you sleep? Do you eat? Are you happy?
     
    Sometimes, there are positive features to caregiving. Only 50% of caregivers are depressed, which means that 50% are not depressed. They find solace in their caregiving, as well as power. It’s an empowering task. Mastering different aspects of caregiving can be rewarding, as can trying to enjoy what you can with your relative with dementia or any other illnesses.
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    A Neurology, answered on behalf of
    Non-caregiver family members also experience psychological distress and think about their loved one who has dementia. This can trigger stress and health effects that need to be addressed as well. Children in the household may become confused about what’s going on with their relative who has dementia or Alzheimer's disease, becoming embarrassed by their behaviors. Counseling can help families and children work through these emotions and deal with their role changes.
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    A Neurology, answered on behalf of
    Depression due to caregiver stress is not necessarily eliminated or reduced when a loved one dies. It results in bereavement and grief following the death. Further, male and female caregivers typically vary in their responses: men tend to get more depressed after the death of their spouses, while women tend to improve.
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    A Neurology, answered on behalf of
    Over time, it is extremely difficult to remain patient with a family member who has dementia. There are several ways of dealing with this. Fundamentally, a family member with dementia who has behavior problems has to be seen and treated by a care provider who specializes in managing behaviors. 


     
    Often, for example, your loved one won't like bathing or grooming. Professional advice can help, providing strategies ranging from distraction, to pre-medicating before a task, to hiring a professional aide to help out. If the challenge continues, then your loved one might require chronic care for these behavioral problems. 


     
    As far as yourself, as a caregiver you might get annoyed at your family member asking the same question over, despite you answering every time. Distraction can be very helpful for dealing with the repetition while removing the stress of it. You are dealing with a two-year-old, and you use the same tools you would use with a two-year-old. 


     
    Another important thing is to not put any emotion into your caregiving. Just try to be as neutral as possible, understanding that it’s not his or her fault. Empathy and compassion -- imagining reversal of the roles, for example -- can help.
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    A Neurology, answered on behalf of
    Respite care is a short-term placement for a person who needs care while his or her caregiver takes a vacation.


     
    Some nursing homes or residential care facilities can arrange for short-term placement like this. They have professional and certified caregivers who can take care of a person while his or her caregiver takes time off. On the other hand, family members could provide the same service, perhaps rotating taking care of the relatives with dementia or any other illnesses.
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    A Neurology, answered on behalf of
    A number of healthcare specialists can support people with dementia and their caregivers. Geriatric psychiatrists are responsible for treating mental health problems in addition to cognitive decline, providing behavioral management for agitation, psychosis, depression and suicidal behavior. They also help with functional evaluation for long-term-care placement. 


     
    Geriatricians are very helpful in managing a mixture of complex medical and behavioral issues and a complex drug regimen. 


     
    Clinical psychologists and advanced-practice psychiatric nurses can provide therapy for caregivers and social workers, offer counseling and link patients and family caregivers to community resources. 


     
    Activity and physical therapists can be very helpful in organizing activities for the day. An occupational therapist can advise on what’s appropriate for the patient.
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    A Neurology, answered on behalf of
    With the onset of dementia in a loved one, a variety of reactions are common. A caregiver may become overly involved to compensate for the illness and its impairments. A caregiver may refuse help and feel isolated or do too much. 


     
    Another common reaction is anger. A caregiver might ask: Why is this happening to me? What did I do? Why am I involved in this? That’s a reaction that is very toxic for the caregiver. Longstanding problems can emerge if they had not been addressed before, with a lot of blame and guilt going around. Unresolved feelings of anger and guilt can lead to depression. 


     
    On the other hand, acceptance is a positive reaction. Acceptance comes from a full understanding of the disease and its effect on the family. 


     
    Help for reactions like anger, guilt and depression can come from the support system, family members or care providers and home health aides. These people can help caregivers understand that no one person can meet all their loved ones’ needs as well as see consequences of over-involvement that could be detrimental to the loved one and limit his or her independence.


     
    A support group can provide empathy from others, which can help a caregiver overcome feelings of guilt and anger (when severe anger is present, individual counseling can be of help).
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    As a caregiver, try to rethink frustrating situations and respond to them differently. The way you think can affect how you feel. A common negative thought pattern is personalizing. You take responsibility for a negative occurrence that is beyond your control. For example, you might blame yourself when the person in your care requires hospitalization or placement in a facility.

    A healthy adaptive response would be: “Mom’s condition has gotten to the point where I can no longer take care of her myself. It is her condition and not my shortcomings that require her to be in a nursing home.”
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    As a caregiver, try to rethink frustrating situations and respond to them differently. The way you think can affect how you feel. A common negative thought pattern is labeling. You identify yourself or other people with one characteristic or action. For example, you put off doing the laundry and think, “I'm lazy.”

    A healthy adaptive response would be: “I'm not lazy. Sometimes I don’t do as much as I could, but that doesn’t mean I'm lazy. I often work hard and do the best I can. Even I need a break sometimes.”