BECOME A MENTOR
Dementia, in its many forms (Alzheimer’s is the most common dementia), disrupts many processes in the brain, usually beginning with memory, progressing to thinking, making decisions, and emotional control. As dementia progresses, these and other issues become more troubling. One striking aspect of dementia is the enormous variability in the effect of the dementia on each person. As some have said, “If you know one dementia patient, you know one dementia patient.” Many patients exhibits massive changes in their functioning. A pleasant, kind, cooperative person becomes mean and uncooperative. Or a more unpleasant person becomes nicer than ever. Some retain the same basic personality, but with increasing memory and thinking issues. In the progression, many will show emotional differences, often showing sadness, anxiety, and/or unexpected anger.
Caregiving for a person with dementia is generally complex and confusing. Generally the caregiver is a relative (spouse or parent typically) who is very well known to the person with dementia. This person with dementia is now exhibiting unusual reactions and behavior.
“This is a person I have known for many, many years; they are still the same person, but there are striking differences. And about the time I have adjusted to who she is, there are further confusing changes. I read about all of this, but the articles/books don’t really tell me how to deal with the specific changes I see happening. The person with dementia who is described in this article is not at all like what I have to deal with involving my relative/friend. She/he is upset much of the time. And, because of that, I am upset, too.”
Dementia caregiving is troubled, in part due to the changed person and relationship.
Each one is unique with unpredictable strange emotions and behavior. The needed advice and support is difficult to find.
MENTORING FOR DEMENTIA CAREGIVERS
Mentoring pairs someone with some expertise with another who is newer to the job. There is a personal relationship where the mentor helps the mentee develop the knowledge and skills needed for the focal tasks. But good mentoring is different than instruction and not simply giving advice or direction; good mentoring requires the mentor to listen, question, problem solve, and provide emotional support. Mentoring for dementia caregiving emphasizes all of these aspects; the mentor needs a broad understanding of dementia and knowledge of resources for caregivers. Most of all, the mentor should have strong empathy and deep understanding of the experience of managing the uinique nature of dementia caregiving, enhanced by the mentors own continuing role as a dementia caregiver.
CASES. David has been involved in several caregiver mentoring situations. In one specific case, I managed by phone with an out-of-state friend of a friend. The woman Marsha (pseudonym) was managing her husband Jerry (pseudonym), who was apparently mid-stage Alzheimer’s. (Note: Out of state by telephone mentoring is especially hard.). He was still an active person and went to his office daily, where he reportedly watched television rather than working. In the evening and weekends, he was difficult, demanding constant attention and required being waited on. Marsha was very distressed, rattled, even overwrought as we talked on the phone. She worried about him at “work,” largely because of the pistol he carried. She hired a younger man to be with him for safety, but he generally told that man to “go away” and the man did so, telling her he had some fear of the weapon. At home Jerry was difficult to get along with—unhappy if her reactions were not what he wanted and he was easily angered. Her medical appointments to have a physician address the developing dementia were canceled, as he always found the appointments on line and canceled. He spent much money on an office and a woman employee who was apparently taking more money than her pay, which itself was not needed because the business was not operating at all.
Advice for Marsha: Find a way to remove or disable the gun, as it could be fired at someone unjustifiably; dementia reactions are often unpredictable. Find ways to calm yourself, whether meditation, yoga, or tranquil thought about a place on the beach or some such. Most of all, call offices at the state, county, or city level that are there to support addressing dementia issues. And groups, such as the Alzheimer’s Association and the Dementia Society of America, should be contacted. She should push hard on the set of problems she is facing soon, anticipating serious problems if she waits. And she should use use that knowledge to manage the right medical visit. Find, from these sources, what agencies provide more direct specific information about managing the day-to-day problems faced by a dementia caregiver. The time was now (or very soon) to declare him incompetent in terms of financial and other legal issues. Of course, she should review existing legal documents to learn what is in his Will, Medical and Financial Power of Attorney, and Medical Advance Directive, to determoine what these documents provided for addressing present/coming issues. The reported that one of their children was engaged enough to be helpful with these issues; get his direct involvement and support. This was all on the fly by me over a prolonged conversation. Get help!
In an extended followup conversation, I only learned that Marsha had begun to move in all of these areas, making further contact with the physician Jerry had always canceled. She talked with the son who could assist. I was able to provide phone numbers for offices at the state, county, and city for her to call. The gun issue was unresolved, but she well understood the risk. Significantly, she had already made a significant effort toward calmness; they had gone out for a wonderful dinner together and returned home to a peaceful evening. This was a limited, but productive mentoring involvement, limited by the circumstances of a distant state, telephone contact with someone never known or seen, etc. At least Marsha now had many actions that would improve the situation.Dementia, in its many forms (Alzheimer’s is the most common dementia), disrupts many processes in the brain, usually beginning with memory, progressing to thinking, making decisions, and emotional control. As dementia progresses, these and other issues become more troubling. One striking aspect of dementia is the enormous variability in the effect of the dementia on each person. As some have said, “If you know one dementia patient, you know one dementia patient.” Many patients exhibits massive changes in their functioning. A pleasant, kind, cooperative person becomes mean and uncooperative. Or a more unpleasant person becomes nicer than ever. Some retain the same basic personality, but with increasing memory and thinking issues. In the progression, many will show emotional differences, often showing sadness, anxiety, and/or unexpected anger.
Caregiving for a person with dementia is generally complex and confusing. Generally the caregiver is a relative (spouse or parent typically) who is very well known to the person with dementia. This person with dementia is now exhibiting unusual reactions and behavior.
“This is a person I have known for many, many years; they are still the same person, but there are striking differences. And about the time I have adjusted to who she is, there are further confusing changes. I read about all of this, but the articles/books don’t really tell me how to deal with the specific changes I see happening. The person with dementia who is described in this article is not at all like what I have to deal with involving my relative/friend. She/he is upset much of the time. And, because of that, I am upset, too.”
Dementia caregiving is troubled, in part due to the changed person and relationship.
Each one is unique with unpredictable strange emotions and behavior. The needed advice and support is difficult to find.
MENTORING FOR DEMENTIA CAREGIVERS
Mentoring pairs someone with some expertise with another who is newer to the job. There is a personal relationship where the mentor helps the mentee develop the knowledge and skills needed for the focal tasks. But good mentoring is different than instruction and not simply giving advice or direction; good mentoring requires the mentor to listen, question, problem solve, and provide emotional support. Mentoring for dementia caregiving emphasizes all of these aspects; the mentor needs a broad understanding of dementia and knowledge of resources for caregivers. Most of all, the mentor should have strong empathy and deep understanding of the experience of managing the uinique nature of dementia caregiving, enhanced by the mentors own continuing role as a dementia caregiver.
CASES. David has been involved in several caregiver mentoring situations. In one specific case, I managed by phone with an out-of-state friend of a friend. The woman Marsha (pseudonym) was managing her husband Jerry (pseudonym), who was apparently mid-stage Alzheimer’s. (Note: Out of state by telephone mentoring is especially hard.). He was still an active person and went to his office daily, where he reportedly watched television rather than working. In the evening and weekends, he was difficult, demanding constant attention and required being waited on. Marsha was very distressed, rattled, even overwrought as we talked on the phone. She worried about him at “work,” largely because of the pistol he carried. She hired a younger man to be with him for safety, but he generally told that man to “go away” and the man did so, telling her he had some fear of the weapon. At home Jerry was difficult to get along with—unhappy if her reactions were not what he wanted and he was easily angered. Her medical appointments to have a physician address the developing dementia were canceled, as he always found the appointments on line and canceled. He spent much money on an office and a woman employee who was apparently taking more money than her pay, which itself was not needed because the business was not operating at all.
Advice for Marsha: Find a way to remove or disable the gun, as it could be fired at someone unjustifiably; dementia reactions are often unpredictable. Find ways to calm yourself, whether meditation, yoga, or tranquil thought about a place on the beach or some such. Most of all, call offices at the state, county, or city level that are there to support addressing dementia issues. And groups, such as the Alzheimer’s Association and the Dementia Society of America, should be contacted. She should push hard on the set of problems she is facing soon, anticipating serious problems if she waits. And she should use use that knowledge to manage the right medical visit. Find, from these sources, what agencies provide more direct specific information about managing the day-to-day problems faced by a dementia caregiver. The time was now (or very soon) to declare him incompetent in terms of financial and other legal issues. Of course, she should review existing legal documents to learn what is in his Will, Medical and Financial Power of Attorney, and Medical Advance Directive, to determoine what these documents provided for addressing present/coming issues. The reported that one of their children was engaged enough to be helpful with these issues; get his direct involvement and support. This was all on the fly by me over a prolonged conversation. Get help!
In an extended followup conversation, I only learned that Marsha had begun to move in all of these areas, making further contact with the physician Jerry had always canceled. She talked with the son who could assist. I was able to provide phone numbers for offices at the state, county, and city for her to call. The gun issue was unresolved, but she well understood the risk. Significantly, she had already made a significant effort toward calmness; they had gone out for a wonderful dinner together and returned home to a peaceful evening. This was a limited, but productive mentoring involvement, limited by the circumstances of a distant state, telephone contact with someone never known or seen, etc. At least Marsha now had many actions that would improve the situation.