Rx FOR CAREGIVERS
Dr. Alan Dengiz prescirbes relief for caregiver burnout
BY:MARC LICHTER
Alan Dengiz, MD, board-certified in internal medicine and geriatrics, is the director of geriatric medicine at St. Joseph Mercy Health Systems in Ann Arbor, Michigan. He is also medical director of Glacier Hills Retirement Community and Huron Woods Alzheimer's Residential Center. He offers these thoughts on men, Alzheimer's and caregiver burnout:Caring Today: How can caregivers-especially men-avoid or prevent burnout?
Dr. Dengiz: The most important thing is to consult your own physician, if the doctor is different from that of your loved one. Your physician should know what you're going through in order to help you.
[Caregivers] have to find time for themselves. And they can't feel guilty that they can't do it all. This is a difficult disease to care for; that person is changing all along and you have to have an understanding of that. There are resources in your community. Know how to access them. Get in touch with the Alzheimer's Association; they have so many resources. Also, there's adult daycare and respite care.
Men don't know how to ask for help, either. Go to your friends, go to your family, see what kind of resources they may have. Don't be afraid to ask. One of the critical things is that people get really depressed because they feel they can't do it all. Talk about the issues. Seek support groups. Men, in particular, will ask me: "Why do I need that? I can cope, I can do this." But they need it. I tell them to just do it. I write that out to the caregiver on a prescription pad: "Just do it!"
CT: We recently interviewed the actor Hector Elizondo [click here for that Caregiver Profile], who related the difficulties his family faced when his mother suffered from Alzheimer's in the late 1960s and early 1970s. From the days when Hector's parents were involved with Alzheimer's to now, there have been major advances in medication. Do you think these meds ease the problem for the caregiver?
AD: I do. There are different classes of drugs for different individuals, and some have had very impressive responses. These medications can hold people at a higher level of functioning longer, which is why we speak so much about getting an early diagnosis. I'm pretty convinced that, after doing this for 25 years—and we've only had these drugs for about 10 years-these medications do make a difference. In some people, you really don't notice a difference but we hope to stabilize them. But everybody deserves an opportunity to be on them. I think a lot of physicians don't recognize the potential benefit of these medications.
CT: What's the negative impact of caregiver burnout on the patient?
AD: People with Alzheimer's are still sensitive to verbal, facial and body language cues that come from the caregiver. Especially in the early stages, when they have some cognition of their disabilities, they are able to identify another's anger. If someone is angry with them because they can't get themselves dressed or because they're taking too long to eat or because they want to go somewhere, that can be very hard on the person with AD. True, they'll probably forget it sooner than someone else, but during that time it increases the stress and the anxiety.
Another thing I think caregivers should understand is that, for just a minute, they have to step back when they can and recognize that the response they're getting from the person with Alzheimer's disease makes sense in the context of that person's loss of memory—even if it may not make sense to the caregiver at that point in time.