The Dementia Caregiver's Toolbox

Dementia Caregivers Make Sacrifices

A recent study from the National Alliance For Caregiving gave some shocking statistics on the burdens of caregiving, including caregiving to those who have dementia.

Dementia Behaviors May Be Helped By Acupressure

A recent study published in the Journal of Clinical Nursing in the UK says that using a technique called acupressure can significantly reduce agitated behavior in persons with dementia.

Dementia Survival Rate Study Surprises

Many people were startled this week to hear the news from the British Medical Journal that the average time from a dementia diagnosis until death was a little over 4 years!

Caregiver O'Connor Accepts Dementia Reality With Validation

The dementia community has found a new person who is shining the light on some of the challenges of caregiving.  Retired Supreme Court Justice Sandra Day O'Connor is using validation to deal with her husband's relationship with another resident at his assisted living facility in Phoenix.

Dementia Caregivers Are Hidden Patients

The Fredericksburg News recently wrote an article about a guide for caregivers called, "Practical Guide To Caring For Caregivers". The topic is not so unusual but it is important to note that the original article was published in American Family Physician in 2000 by Susan Mockus Parks, M.D. and Karen D. Novielli, M.D. Sadly, nothing much has changed since the authors first noted this issue six years ago. The article was referenced by Karl Karch of Home Instead Senor Care as he spoke at a meeting of the Fredericksburg Regional Chamber of Commerce. In fact the needs of the dementia caregiver may be as great or greater than the actual person with dementia. As physicians themselves and part of Thomas Jefferson University Hospital in Philadelphia, Parks and Novielli coined the term "hidden patients" to describe the caregivers who accompany the person with dementia, yet have great burdens to deal with along with depression and anxiety. The authors suggest that family physicians have a responsiblity to recognize significant caregiver burden and offer the dementia caregiver appropriate interventions or coping skills. This should make sense to physicians when you consider that these stressors increase the risk of the person with dementia needed advanced services such as long term care placement or home health care. The article offers the Zarit Burden Interview (22 questions) or the much simplier set of eight questions that a physician can use with the caregiver to quickly determine what services the caregiver may require. A sample question is "Have you been feeling more anxious and irritable lately?". The Practical Guide To Caring For Caregivers also includes a table with significant resources, from the Alzheimer's Association to the Well Spouse Foundation. This article is more important than ever as the numbers of dementia caregivers and dementia patients keeps escalating. Make sure your physician is informed. Go to www.aafp.org and type in "Practical Guide to Caring for Cargivers". Print out the article and bring it along to your next visit.

Dementia Caregivers: If You Want Something Done, Find A Busy Person!

Here is a surprise (NOT!): researchers at Cornell University are reporting that older women who are mothers select their daughters as caregivers over their sons almost four times to one!!!!! Somehow, all of us gals out there intuitively knew this already! As the oldest daughter with two younger brothers, I was the hands-down winner in the caregiver selection contest when my mom was ill with Parkinson's and related dementia. It's funny; I don't even remember a single conversation, debate or discussion. It just was what it was. I was elected because I was the oldest (smarter somehow?) and of course, let's not forget the "girl thing". My mother unconsciously chose me and I slipped like a glove into that role. For the record, my brothers did help but I was the point person. The brilliant scientists who worked on this project also stated that complicating factors that the selected daughter's might have such as marital issues, health/legal problems, etc, had no bearing on the ultimate choice by the mother. The mother's weren't being particularly practical about who should do it, it appeared gender-based, despite available sons. The study was done in the Boston area with a large sample that included in-person interviews and much detailed data. Although the information is interesting, we could have saved you the trouble! For more info go to: www.human.cornell.edu/che/bio/crm?netid=kap6

Dementia Caregiver Characteristics Linked To Dementia Behaviors

Why would younger dementia caregivers report MORE behaviors than some of their elder caregiving counterparts? 

The answer to that puzzling question is not yet known but it appears that the recent study from Wake Forest University School of Medicine has unearthed a new obstacle in trying to help the person with dementia:  their caregiver.

A recent article, published in the Journal of the American Geriatrics Society, looked at behavioral symptoms shown by persons with dementia.  These behavioral symptoms could range from wandering and repetitive questions to combativeness and danger to others.  After adjusting for variables, the researchers were shocked to learn that caregivers with less education, who were younger in age, more depressed and had more hours per week spent in caregiving, reported seeing 50% more behaviors in their person with dementia!

Researchers are now seeing that more of a focus needs to be placed on learning about the caregiver-patient relationship as there are many factors which can influence the behaviors of the person with dementia.  All agreed, that this study and the growing/aging baby boomer, points to more caregiver education and support being needed.

Dementia Interventions: Nintendo Anyone?

We've been hearing much lately about research out of Japan which suggests that using Nintendo games can actually give your brain some exercise. Any of these mechanical exercises are supposed to help the part of your brain that helps you store knowledge, the prefrontal cortex. The theory here, proposed by Japanese neuroscientist Dr. Ryuta Kawashima, is that the "age" of your brain needs to be determined and then a series of training programs are instituted to help your brain regain some of its former glory. Many people have been watching these announcements from Japan with a mix of curiousity and bewilderment. Some studies have even reported that a few million Japanese game players have seen some positive aging reversals. The dementia professionals watching from the wayside would probably have continued for a while until we heard the surprise endorsement of videogames by the National Executive Director of the Australia Alzheimer's Association yesterday. Using the video games (and mentioning Nintendo directly), Executive Director Glenn Rees, unveiled his main message of keeping the mind active. No surprise to hear that Sony, Sega and others are all prepping to launch brain workout games soon. What's next for baby boomers to ward off dementia? Skateboarding and hanging out at the mall?

Dementia Caregivers Should Look For Unrecognized Anxiety

Before caregivers jump to the conclusion that the behavior they are seeing is agitation, they need to stop and consider that it just may be anxiety. At the 26th Annual Conference of the Anxiety Disorders Association of American or ADAA, presenters suggested that anxiety in patients with Alzheimer's Disease is not being recognized regularly. The researchers, led by Dr. Gene Cohen of George Washington University, offer that patients with Alzheimer's disease may have anxiety driven by challenges such as unstructured environments, changes in the environment or facing difficult situations or requests to complete tasks. Lacking screening devices to check for anxiety in patients with Alzheimer's or other dementias, the recommendation is to continue to read the signs of anxiety intuitively. Most caregivers have already adapted to using various forms of communication to fill in the gaps, so looking for anxiety symptoms will be no different. Reading body language and recognizing behavior as a unspoken need are the first steps. The ADAA offers info on anxiety at: www.adaa.org/Gettinghelp.

Dementia Caregivers: Gingivitis problem?

Just when you thought that dementia caregivers had enough to deal with, now we find out the their teeth are in danger too.  A new study recently cited in the Journal of Periodontology (and mentioned on alzinfo.org )is suggesting that physical stress that occurs over a long period of time may lead to increased gum bleeding or gingivitis.  Dementia caregivers are certainly a group with high levels of stress.

I just picture the caregiver of the person with dementia, rendering oral care on a regular basis to their dementia family member or client.  While this activity is going on, along with numerous other stressful tasks of dementia caregiving, their own physical health is slowly fading away.  Faced with little free time, I wonder how many caregivers take care of themselves properly?  I think that more and more research will be coming out to show that we need to take care of the caregivers too!