Understanding Mental Health

Family members can react in unique and individual ways when a loved one is diagnosed with Dementia. The most common reactions are outlined below:

DENIAL: Reflects the initial response that nothing is wrong. Denial is a natural reaction; can prevent a family from seeking help; can create family conflict. Helpful Interventions: Provide accurate information on Dementia when appropriate; Listen without judging; Do not assume person is in denial. There may be a lack of information amongst family members.

OVER INVOLVEMENT: The primary caregiver may try to meet all the needs of the person with memory loss and refuse help from everyone; caregiver believes they are helping; can create a barrier to getting further help. Helpful Interventions: Involve family member in care and care planning; Encourage family member to express painful feelings such as guilt, loss and anger.

ANGER: Resulting from the physical, emotional, financial burden of providing care. Can stem from feelings of loss and abandonment. Angry feelings can cause guilt. Helpful Interventions: Discuss anger at the disease rather than at people. Encourage interaction with other families going through the experience. Listen without judging or taking sides. Encourage caregiver to take some time for his/her self.

GUILT: A feeling that comes from a sense of wrongdoing in words, actions or thoughts. Guilt can come from: Old conflicts; Placement and other tough decisions; Feeling like you “have not done enough”. Helpful Interventions: Learn about guilt and how it affects clients’ families; Encourage caregiver to talk about guilty feelings if appropriate.

ACCEPTANCE: This is possible when the process of the disease and its effect on others is fully understood. Remember, families can still revert to earlier stages of adjustment. Helpful Interventions: Enable caregiver to see setbacks as temporary; Encourage caregiver to pursue personal interests and hobbies; Encourage involvement in care (if appropriate) and continue to ask their help/support on issues of caregiving.

It is important that both families and caregivers can develop strategies that help them to cope with caring for the client with Dementia. Effective strategies are outlined below:

– Learn about Alzheimer’s to understand what is happening to the client with Dementia.
– Develop realistic expectations about the future.
– Accept past mistakes. Learn from them and go on.
– Become aware of your own mental and physical reactions to stress.
– Accept and enjoy your successes and breakthroughs, but accept that they are temporary.
– Accept your own feelings of frustration or anger at the person with Alzheimer’s.
– Realize that taking out these feelings on the person with Alzheimer’s is not appropriate.

Summary

• Dementia refers to a spectrum of brain disorders, involving difficulty with memory and thinking; symptoms vary in their causes, courses and prognoses.
• Symptoms of Dementia include: decline in memory, thinking and reasoning; change in personality, mood and behavior; difficulty communicating, recognizing people and places and engaging in activities.
• Alzheimer’s disease is the most common form of Dementia. It is progressive and irreversible. Early diagnosis and recognition of symptoms is important for care.
• When treating an Alzheimer’s patient with medication, remember that it should be administered for the benefit of the patient and not for staff convenience.
• Vascular or Multi-Infarct Dementia, is the second most common form of Dementia, estimated to account for approx. 20% of cases. It is caused by reduced blood flow to parts of the brain, often due to tiny strokes which block small arteries.
• Fronto-Temporal Dementia causes personality and behavioral changes and loss of language function.
• Lewy Body Dementia is caused when abnormal protein deposits called Lewy bodies are left in the brain; symptoms include hallucinations and memory loss. The early stage lasts for two to four years. It is characterized by forgetfulness, increasing difficulty with problem-solving and withdrawal from activities. The middle stage is characterized by increase in memory loss, confusion, shorter attention span, increase in language difficulties and repetitiveness. The late stage is a period of severe confusion and loss of all functional skills; the person has no awareness of their condition. This lasts for approx. 1-3 years and ends in death.
• Caregivers (professional or family members), must take steps to safeguard their own health and well-being when caring for others.