Acquiring special skills for Alzheimer’s care
Caregivers learn techniques for relating to patient
Education is key for family members who care for loved ones with Alzheimer’s disease. In order for the patient and the caregiver to have a good quality of life, the caregiver must learn techniques for working with Alzheimer’s disease patients and understand how to build a support system to help in the care. If this is not done, the caregiving situation can create stress for the family and even result in health problems for the caregiver, experts explain.
First and foremost, caregivers should understand the progression of the disease, says Kara Albisu, MSW, director of quality care initiatives for the Alzheimer’s Association in Chicago. "If they don’t understand what is happening, many times they misread the behaviors of someone with the disease," she explains.
Over time, more and more brain cells die when a person has Alzheimer’s disease. As the disease progresses, patients lose their short-term memory and may ask the same questions over and over. When caregivers don’t understand the disease process, they might become annoyed by the questions. "If they understand the impact on recent memory, they react differently," says Albisu.
Knowing the signs and symptoms of Alzheimer’s is important for the general health of the patient as well. Because Alzheimer’s patients cannot always communicate what they are thinking and feeling, their behavior may not be a result of the dementia, but a health problem such as pain. If the caregiver can distinguish between Alzheimer’s symptoms and other behavior, they can seek appropriate health care intervention, explains Albisu.
As patients lose verbal communication skills, caregivers need to learn how to supplement verbal cues with physical cues. For example, rather than simply calling out to the patient that it is time for lunch, the caregiver will need to go to the patient and guide him or her to the table. "You are no longer orally guiding, but through your body language and gentle guiding, you indicate where you want to go. So it is supplementing oral communication with physical cues," says Albisu.
When verbally communicating, caregivers should use short, uncomplicated sentences. For example, the caregiver should simply tell the patient it is time for lunch, rather than asking if he or she is hungry or ready to eat lunch. Such conversation puts pressure on the Alzheimer’s patient to respond. That causes frustration, which could result in negative behavior.
The caregiver needs to keep abreast of what the patient is still capable of doing and structure the day around experiences that reflect what the patient’s normal pattern was like as an adult. While it is often easier to dress the patient, it is important to break the process down to little steps that the patient can do with minor support.
"The task is rewarding to them because they are still being treated as an adult with respect and dignity," says Albisu. Determine whether the patient is still interested in activities he or she liked before, such as oil painting, but don’t rule out activities the patient didn’t like. Patients may enjoy doing the activity now, she advises.
It’s important to make sure that the Alzheimer’s patient has recreational activities, agrees Sandra Fong, MS, administrator at Gramercy Court, a health care residence with an Alzheimer’s unit in Sacramento, CA. The caregiver might look for such opportunities within the community. As soon as a loved one is diagnosed, it’s important to begin investigating services that are available. For example, make a list of adult day care centers that includes their patient criteria, activities, and cost.
The biggest adjustment for the caregiver is getting used to changes in the loved one who has Alzheimer’s. The personality of the patient deteriorates as Alzheimer’s progresses. Meaningful conversations and bonding activities that were part of the former relationship are no longer possible.
Therefore, caregivers must find new ways to connect with the loved one and bring a smile to his or her face. "The caregiver needs to find different ways to experience some pleasure or joy with their loved one," says Albisu. (For more information on coping techniques for caregivers, see article on p. 68.)
For more information on educating caregivers of Alzheimer’s disease patients, contact:
• Kara Albisu, MSW, Director, Quality Care Initiatives, Alzheimer’s Association, 919 North Michigan Ave., Suite 1000, Chicago, IL. 60611-1676. Telephone: (312) 335-5761. Fax: (312) 335-1110. E-mail: [email protected]. Web site: www.alz.org.
• Sandra Fong, MS, Administrator, Gramercy Court, 2200 Gramercy Drive, Sacramento, CA 95825. Telephone: (916) 482-2200. Fax: (916) 482-1120. E-mail: [email protected]. Web site: www. gramercycourt.com.
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