How to Reduce the Stress of Caregiving by Individualizing Your Approach with a Family Member with Dementia
Authored by Joseph M. Casciani, PhD
Living longer means that physical decline will typically accompany our later years. This may be in our sensory systems, agility and balance, mental function, communication skills, or the myriad chronic diseases that we see in old age. And, as our population ages, more caregiving is being provided by family members and other caregivers who are not paid health care professionals. A report by the Mayo Clinic found that about 1 in 3 adults in the US provides care to other adults as informal caregivers.
There are many recommended strategies for caregivers to reduce their level of stress and burnout. Requesting and accepting help, joining a support group, staying connected with others, and others are useful steps. One approach that is often overlooked is the notion of prevention. One preventive strategy is accomplished by individualizing the way we interact with the family member who needs an extra measure of care due to the onset of a dementing illness.
To be sure, caregiving comes in all shapes and sizes, depending on the functional capacities of the care recipient. Whether it is a spouse, sibling, or parent, we know that caring for an ill, bed-ridden person requires strategies that are quite different from those needed for the person with moderate to advanced dementia who is living at home. Nonetheless, individualizing our approach when caregiving for those with cognitive impairment, two features stand out. These are two-way communication and tolerance for differentness. This means individualizing our approach to the unique needs of the care recipient, focusing on listening more than advising, and collaborating on solutions and fixes. These approaches will be more effective overall and will be more respectful of the person we are helping.
Individualized Care Means Two-way Communication
Our loved ones must have an opportunity to ask questions and to voice their anxieties and fears about what can be expected in their future. Ideally, they have a say in what goals should be set in their care. Instead of two-way communication, one-way communication from the caregiver to the care recipient is an unhelpful, outmoded approach. It leaves the person with limited cognitive capacity unable to adapt successfully to the changes he or she is facing. We increase the chances of better coping when the care recipient has enough information to make informed decisions and becomes part of the day-to-day planning as well as long-term goals.
When we overlook or minimize the person’s involvement in his or her own care, and do not take the time to really hear what he or she wants, compliance is likely to be superficial and temporary. And often a decline in functioning can be expected.
Individualized Care Means Understanding the Diverse Interests and Needs of Our Loved Ones
Individualized care means acknowledging that a parent or spouse will voice unique needs and desires different from what we think are best. This tests our patience and tolerance, and our role as the protector. But, stepping out of our own protective role in even in the smallest way, and making the occasional exception can make a significant difference for the person who is only seeing decline and loss. Allowing mom to visit friends or continue with her trips to the gym creates opportunities for maintaining her quality of life. Or enrolling the husband who has Alzheimer’s disease in harmonica lessons – an activity that is very plausible for certain dementias – offers relief and gratification for the caregiver wife. It respects the person’s remaining decision-making capacity and puts the spotlight on residual strengths.
True, we must manage the risks that come with this level of independence. But we also know that compromises and alternative solutions are always available. We want to protect a family member from harm, of course. However, allowing the person to stay involved in desired activities of daily living or different self-care activities fosters a sense of purpose and meaning and keeps the fire burning.
Resources and Solutions to Reduce Caregiver Stress
General Resource Books and Activities:
- Caring for Your Parents: AARP Guide on Coping with the Challenges of Caregiving
- The 36-Hour Day: A Family Guide to Caring for People with Dementia and Memory Loss
- Three-deck Set of Conversation Cards for Mental Stimulation and Life Review
- Puzzle, Games and Activity Book for Mental Exercises
Closing
Caregiving is a stressful, demanding, and frustrating activity. Caregivers are put in a new role, a role that is both unexpected and undesired. Trying out these two strategies can serve as stress reducers. This is, first, active two-way communication and second, co-existing with different desires and keeping the door open to different behaviors. The recommended books and activities can also help.
Dr. Joe Casciani is the owner and Chief Curator for the Living to 100 Club, a source of solutions to living longer and healthier, with a special focus on mindset and attitudes about aging. He has a 40-year history as a psychologist and manager of mental health practices specializing in behavioral health services with older adults. In addition to his work as a clinical consultant, he is an engaging and inspiring speaker, and helps audiences move beyond their questions and concerns about aging to create a vision of what is possible in the years ahead. He strongly believes there is value in helping people feel inspired about their future.
