Growing old with dignity

Usually the longest stage of Alzheimer’s, the middle stage is far more challenging than the early stage. During the early stage, the focus is on basic caregiving, such as establishing routines, creating a safe and familiar environment, encouraging social activities and providing companionship. Most of this can be handled by the partner or relatives of the person with Alzheimer’s.

As dementia progresses, however, you will begin to take far more emotional strain and your loved one will become harder to cope with. At this stage you need to enlist as much help and support as you can muster. Bear in mind that because this stage could last for many years, you need to make sure that you take care of yourself.

You will begin to notice significant behavioural changes to the extent that your loved one becomes virtually indistinct from the person you have known. It may distress you to see that he or she can no longer dress themselves, or that they completely abandon any attempts to maintain personal hygiene. You will eventually become very frustrated that he or she no longer responds to even basic communication. You might also become scared when severe mood swings, including visible anger, set in. As sleeping patterns are disturbed you will feel physically tired and emotionally drained.

Here are some tips on how to cope:

• As hard as it is, try to remember that the person you are seeing now is not the person you married or who raised you. It doesn’t help to get angry because they no longer function as they used to.
• Talk calmly and gently. Don’t raise your voice when he or she is uncooperative.
• Provide reassurance if it is obvious that your loved one is becoming agitated.
• If you notice dramatically deteriorating behaviour, find out from your doctor whether it could be due to his or her medication.
• Do not burden yourself with guilt. None of this your fault.
• Don’t expect to have the right answer to every challenge. It will take time to learn the various coping skills.
• Friends and relatives may find it awkward to visit. Share your knowledge with them and encourage them to visit, even if it is for short periods.
• Don’t isolate yourself. You need to interact outside of the caregiving relationship that you have taken on.
• Get respite. You are going to have moments when you feel despair and exhaustion in equal measure. Give yourself a break. Find a way to go out for lunch with friends, or to visit places that are close to your heart.
• Make firm plans for your financial position. Long-term care can be expensive and you need to evaluate to what extent you can afford it.
• Never be afraid or ashamed to ask for help. Be it family, friends or professional caregivers they can lighten your load and make these difficult times a bit easier to bear.

At some stage, you may find that caring for your loved one is just too much for you to handle on your own but you would never consider placing them in a nursing home, where they will be exposed to unfamiliar surrounds, different routines and the stress of interacting with other Alzheimer’s patients. This is the time to investigate the use of a professional caregiving service with the credentials and expertise to take care of your loved one and provide you with all the tools to cope with daily living needs.