The challenges of caregiving
December 18, 2006
Most people do not choose to become caregivers. A spouse, parent, or relative begins to show a need for care and family members respond. They often do so with limited information, little preparation and no previous experience or training. Giving care to a loved one may be a privilege and a source of satisfaction, but it also is a huge responsibility. When helping someone with a physical illness like arthritis, heart disease or respiratory illness, families can usually continue to interact in their usual way, work together to solve problems, make decisions and enjoy each other’s company. On the other hand, though dementia also is a physical illness, its symptoms appear as cognitive and psychological changes, thus posing enormous challenges to relationships and communication.
“In medical terms, dementia is a condition of progressive, global deterioration of memory and cognition that impairs thought and social functioning,” according to the Alzheimer’s Association. It is a disease and not a part of normal aging. The most prevalent cause of dementia is Alzheimer’s disease. Although changes in memory may be the first symptom to become obvious, other cognitive changes can appear in reasoning, judgment, language, attention, perception, abstraction and organization. These changes in personality and social functioning have a tremendous impact on families and their ability to provide care. The emotional and physical strain may be overwhelming. Family members must learn new strategies to accomplish goals and they must become masters at adaptation.
As caregivers of all kinds adapt to their new role, it is often helpful to identify differing motivations for giving care. Victoria Cotrell of University of Texas talks of three major reasons. The first is affection. When there are warm feelings and love in the relationship, the job can be easier. Most people respond willingly to the special needs of short-term care. Affection can be less a motivation as the dependent relationship lengthens, especially with a dementing illness. A second motivating force is reciprocity, a return of caring which stems from gratitude for what someone has done for you in the past. Often, adult children will say, “My mom/dad has done so much for me. It is my turn to give back.” Many families pride themselves on being there for each other. Finally, obligation may be the most important factor in sustaining a long-term commitment to care. Society and religion teach responsibility for family. Caring for one another until death is written into most marriage vows. Many caregivers will also find other motivating forces.
As family members continue to understand themselves as caregivers, it is important to identify personal strengths and weaknesses in a realistic manner. What is one’s usual coping strategy? Is it humor, diversion, friends, hobbies, or physical activity? What is one’s own physical and emotional health? Do grief, loneliness, anger, guilt or depression enter into the equation? Are the care requirements too physically demanding? Is there a strong support system for both the caregivers and the care recipient? And finally, what had gotten those involved through the hard times before? Answering these questions will help caregivers make the experience more manageable.
Providing care for another person is probably one of the most demanding, challenging while, at the same time, rewarding roles that families will ever assume. There are no neat formulas for, or definitions of success. Yet, through self-awareness, dealing honestly with feelings, learning care techniques, and gaining information about resources, caregivers can develop strategies for coping and experience a sense of control.
The Alzheimer’s Association will sponsor a caregiver information and support group for those caring for someone with dementia, whether hands-on or long distance, beginning Thursday, Jan. 4, 2007, from 12:30 to 1:30 p.m., in the VNA lounge of the Yampa Valley Medical Center. For information or questions, call Barbara Bronner at 879-8942.