A Caring Crisis
Many countries around the world, from the USA to China, are facing the problems of an aging population and with it, the implications of a large number of elderly people with Alzheimer’s disease and other neurodegenerative diseases that cause severe memory loss. As medical science prolongs our lives and more of us make it into our 80s and 90s, statistically more of us are likely to live long enough to manifest the symptoms of Alzheimer’s and other dementias.
Special Requirements for Dangerous Circumstances
Unlike many other chronic diseases where the sufferer is sentient and is aware of what is going on around them, patients with memory loss require very skilled and diligent care. As the disease progresses it becomes increasingly necessary to keep the patient under constant supervision. Potentially dangerous behaviours include wandering, driving, causing fires through starting to cook and then forgetting the stove is on, eating or drinking dangerous substances as they are unable to judge what is edible, accidental drug overdose or forgetting to take vital medications and so on.
Looking after someone with severe memory loss is not just reminding someone who is absent-minded to take their tablets. It is a very real and challenging task for all concerned and should not be under-estimated. Personality and behavioural changes are also part of the progression of the disease and the patient may become aggressive and abusive. This can be particularly distressing and potentially dangerous in the case of elderly couples where a physically frail wife in her 70s or 80s finds herself trying to cope with a husband who is much bigger and stronger than she is but has no idea whatever of what he is doing.
The Importance of Forward Planning
With all this in mind, it is important that as soon as a diagnosis is made and while the patient is still aware of what is going on, plans are made and the patient is engaged in the discussion regarding their long term care arrangements. It is also a good idea to get all financial affairs in order and to get a power of attorney drawn up so that someone responsible can take over their legal affairs. This can save arguments later on.
Safeguards need to be set in place that the burden of care does not fall entirely on the shoulders of one family member, particularly if that person is also elderly. Any resources available for respite care and outside assistance should be investigated and utilised. Regular home help to assist with bathing, dressing and other physically demanding tasks can be helpful, as is someone who can sit with the patient a few hours a week and keep them company while the primary caregiver has some personal time or attends to tasks outside the home such as shopping.
The Search for Caring Facilities
There will come a point in most cases where the patient will have to be transferred to a care facility, not just for their own safety but also for that of their caregiver. This decision should be carefully researched. While few families have generous financial resources, it is important to check that the facility is clean, safe, well-run, has a good reputation and is conveniently located for visits. Look at what activities are also offered. A place where strangers can wander in and out without any security checks or where all the residents are sedated whether they need it or not are signs that all may not be as it should. Price is not the only factor in the equation and not all care facilities are created equal, unfortunately.
After the initial settling in period which may be turbulent and fraught with misguided guilt, many families find that they have a better relationship with their loved one because they can now concentrate on the positive during visits and don’t have to worry about the indignities of diaper changes, bath-time and home safety.