Caring for a Loved One

More than 65 million people, or 29% of the U.S. population, provide care for a chronically ill, disabled, or aged family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one. The value of the services family caregivers provide for “free,” when caring for older adults, is estimated to be $375 billion a year. That is almost twice as much as is actually spent on homecare and nursing home services combined ($158 billion).

November is National Caregivers Month. It is also National Alzheimer’s Awareness Month and National Diabetes Month. 

In this special section on caregiving, we honor all caregivers, with special attention and tips on caring for loved ones who suffer from Alzheimer’s and Diabetes. We also include information on caregiver self-care. 

Alzheimer’s Home Safety Checklist 

People living with Alzheimer’s disease and other dementias can be at increased risk for injury or harm in the home. As the disease progresses, they will become unaware of potential dangers. Consider the following precautions to create a safe environment which can prevent dangerous situations from occurring and help maximize independence for as long as possible. 

General Home Safety Tips

• Store potentially hazardous items such as medication, alcohol, matches, sharp objects or small appliances and tools in a securely locked cabinet.  
• Keep all cleaning products, such as liquid laundry pacs and bleach, out of sight or secured to avoid possible ingestion of harmful chemicals.  
• Keep the number for the local poison control center posted by the telephone in case of emergency.  
• Make sure carbon monoxide, smoke detectors and fire extinguishers are available and inspected regularly. Replace batteries twice a year during daylight saving time. 
• Remove tripping hazards such as throw rugs, extension cords and excessive clutter. 
• Keep walkways and rooms well lit. 
• Secure large furniture, such as bookshelves, cabinets or large TVs, to prevent tipping over.   
• Ensure chairs have arm rests to provide support when going from a sit to stand position. 
• Apply stickers to glass doors at eye-level to ensure the surface is visible. 
• Install a latch or deadbolt on all doors that is either above or below eye level. 
• Remove interior locks on doors to prevent the person with dementia from locking themselves in. 
• Consider removing firearms from the home or storing them in a locked cabinet. 
• Enroll in MedicAlert® + Alzheimer’s Association Safe Return®, a 24-hour nationwide emergency response service for individuals with Alzheimer’s or other dementias 

Kitchen

• Use appliances that have an auto shut-off feature. 
• Prevent unsafe stove usage: Apply stove knob covers or consider removing knobs or turning off the gas when the stove is not in use. 
• Disconnect the garbage disposal. 
• Mark foods with purchase date and frequently check the refrigerator for and discard expired items. 
• Discard toxic plants and decorative fruits that may be mistaken for real food. 
• Remove vitamins, prescription drugs, sugar substitutes and seasonings from the kitchen table and counters. 

Laundry Room

• Clean out lint screens and dryer ducts regularly to prevent fires. 
• Consider installing safety locks to washing machines and dryers to prevent inappropriate items being put in or taken out too early. 
• Install locks to laundry chutes to avoid temptation to climb into or drop inappropriate items down the chute. 

Bathroom

• Install grab bars for the shower, tub and toilet to provide additional support. 
• Set the water temperature at 120 degrees Fahrenheit or less to prevent scalding.  Apply textured stickers to slippery surfaces to prevent falls. 

Garage

• Limit access to large equipment such as lawn mowers, weed trimmers or snow blowers. 
• Keep poisonous chemicals, such as gasoline or paint thinner, out of reach. 
• Lock and properly store ladders when not in use to prevent a tripping or climbing hazard. 
• Remove access to car keys if the individual with dementia is no longer driving. 
• Install a motion sensor on the garage door. 
• Mark stairs with bright tape and ensure railings are sturdy and secure to prevent tripping or falls.

For more information, visit the Alzheimer’s Association at alz.org or call 800-272-3900.

Caring for Persons Living with Alzheimer’s: A guide to the major stages of the disease

More than five million Americans live with Alzheimer’s disease. According to the Alzheimer’s Association, more than 16 million Americans provided an estimated 18.5 billion hours of unpaid care at an estimated value of 244 billion dollars for family and friends with Alzheimer’s disease and related dementias in 2019. Nearly half of all caregivers (48%) who provide help to older adults do so for someone with Alzheimer’s or another dementia. It’s a tragic disease that takes a toll on both the person living with the disease and their caregivers. 

The decision to become a caregiver for a person with Alzheimer’s or another dementia is not an easy one, and the reasons for taking on this challenging role vary. A family may desire to keep their loved one or friend at home; someone may accept the task because they live with or in close proximity to the person with dementia; or a caregiver may have a perceived obligation to the person with dementia. Caregivers often indicate love and a sense of duty when describing what motivates them to assume care responsibilities for a relative or friend living with dementia. As the disease progresses through major stages, the type of care a person living with Alzheimers’ needs changes. 

Early Stage

In the initial stage of Alzheimer’s, which can last for years, most people function independently. They may still drive, visit friends, volunteer, even work. A caregiver’s role (often called care partner in this stage) in this stage is to provide support, companionship, and prepare for what’s to come.

What to do:

• Together, begin making decisions about the future, ie legal, financial, and long-term care planning.
• Consider potential treatment options for your loved one and participation in clinical trials.
• Start to assume more household chores, as appropriate, and help your loved one develop new coping strategies.
• Assess safety issues in the home.
• Avoid situations that may stress your loved one.
• Communicate often with your loved one and ask them what they need and how you can help.
• Find activities to do together that are fun for both of you.
• Help your loved one keep track of appointments, recall names or words, manage money, take medications, and facilitate transportation if they can no longer drive.
• Help your loved one stay healthy for as long as possible: encourage physical activity, prepare healthy meals, maintain a daily routine, reduce stress, and find ways to relax.
• Be mindful of your own emotions. Initially, denial is common for caregivers, but staying in denial for too long wastes valuable time. Other common caregiving emotions include fear, stress/anxiety, anger/frustration, grief and depression. These same emotions can affect the person diagnosed with the disease. Talk together about your feelings. Don’t hesitate to reach out to a professional if you need help.

Middle Stage

The middle stage of Alzheimer’s is typically the longest and possibly the most challenging, in terms of caregiving. Damage to the brain can make it difficult to express thoughts and perform routine tasks. He or she may jumble words, have trouble dressing, get frustrated or angry, or act in unexpected ways, such as refusing to bathe. They may forget how to cook, do laundry, and other everyday tasks. They might be prone to wandering and lose their way. Your loved one may experience depression, anxiety, irritability, and repetitive behaviors. As the disease progresses, other changes may occur, including sleep changes, and physical/verbal outbursts. Communication becomes more difficult, as he or she struggles to find the right word, repeats questions, and loses his or her train of thought. Eating, dressing, and grooming become more difficult. During this phase, a person living with Alzheimer’s should not be left alone and needs a great deal of supervision for safety reasons. This requires the caregiver be flexible and patient.

What to do:

• Take on more responsibility at home. Adapt and restructure daily routines.
• Take care of yourself, take breaks, and lean on your support group. Resist the temptation to isolate yourself. Seek out respite services in your community, and accept offers of help from friends and family.
• Continue to find activities to do together, such as cooking, enjoying music, or going for walks. Find new ways to connect and deepen your bond.
• Consider making the decision to no longer allow your loved one to drive.
• Strive to remain calm when dealing with challenging middle stage symptoms.

Late Stage

This stage can last from several weeks to several years. Around the clock care is usually required. Your loved one may lose the ability to speak and walk. Eating and swallowing becomes difficult. He or she will need full-time help with personal care. They become vulnerable to infections.

What to do:

• In this last, tragic stage, you’ll want to preserve your loved one’s quality of life and dignity. 
• He or she may not be able to communicate well with you, but they may still be able to understand more than you realize, so do interact often. 
• In the late stage, a person with Alzheimer’s experiences his or her world through the senses. So interact by playing favorite music, read to him/her, look at old photos together, prepare favorite foods, massage hands and feet with scented lotions, brush her hair, or sit outdoors and experience nature, weather permitting.
• Ensure adequate nutrition and hydration.
• If care at home becomes too difficult, consider other care options, such as a care facility and hospice.

The Alzheimer’s Association is a valuable source of information for caregivers. Go to alz.org.

As a caregiver, it is vital to maintain your own physical and mental health:

• Think about ways you can get support now. For example, include an afternoon to yourself in your monthly schedule. Ask others to visit or go to lunch with the person living with dementia while you’re away.
• Build a support network. Create a support system before you think you need one to minimize your stress as the disease progresses. Look at current support systems you have already in place and consider the people you turn to most often in times of need.
• Connect with other care partners to acquire encouragement and comfort from others who understand what you’re going through. Learn more about in-person and online support groups.
• Ask for and accept help. Care partners often wait too long before asking for help from others.
• Rest when needed and allow time for yourself and your own interests.
• Try not to take things personally; symptoms of the disease can cause an individual to forget events or commitments. Remember this is not a reflection of his or her character.
• Stay healthy through diet, exercise, and regular visits to the doctor.
• Stay engaged by continuing to be involved in activities that are important to you and enhance your sense of wellbeing.
• Allow yourself the opportunity to laugh when funny situations arise.

Helping Someone you Love with Diabetes

by Lauren Morris

When a friend or family member is diagnosed with diabetes, you might wonder how to best support them on their journey with this new diagnosis. By educating yourself on the disease and learning how to integrate their new lifestyle into your own, you’d be surprised how simple it is to help someone you care about feel a little more at ease when faced with living with a life-changing diagnosis. 

It’s estimated that 425 million people are living with diabetes, and it’s predicted this number will only increase with time. “With diabetes being as prevalent as it is, it’s important that not only are patients educated on what it means to be diabetic, but also that those who are close to patients increase their knowledge of the disease, as well. Knowledge is power, and that is absolutely the case with diabetes,” says Samantha Rider, LDN, RD, CDE, certified diabetes educator with the Endocrinology Center of Southwest Louisiana, an affiliate of Imperial Health. 

If they are willing and you are able, accompanying them to their appointments can also be helpful, especially in the early days after their diagnosis. “The better you understand what diabetes is, the better you can help them and yourself,” Rider says. 

Diabetes education classes are usually recommended for the patient to help them learn more about their condition and its management. Rider says if you are able to attend these classes with your loved one, that is both a great way to show your support and learn more about their condition. These classes will help the patient and family identify appropriate blood sugar target ranges and provide suggestions for the appropriate response if blood sugars are high or low. She explains the classes focus on interactive experiences to help both the patient, their friends and family members to feel informed and comfortable making treatment decisions. 

The good news is that through diet and exercise, and in some cases, medication, diabetes can be managed. When building any new habit, doing it with support makes the change a lot easier. “One of the best things you can do to show that support is to make the same changes they’re having to make,” says Rider. “Implementing a healthier lifestyle will be beneficial to your overall health, as well. You might want to purchase a diabetic cookbook and plan out each week’s meals and then cook it together. Changes are easier to make with someone right by your side.” 

When making lifestyle changes, it’s important to be patient. “For example,” says Rider, “someone newly diagnosed with diabetes won’t be able to just run to the grocery store anymore and rush through, picking up their usual items. They will need to read labels, and they’ll probably need help deciphering all the information a nutrition label provides. Be patient and respectful of their new situation, and help if you can.” 

Some patients are more sensitive than others about asking and receiving help with their new condition. “It’s important not to offer unsolicited advice or criticism,” says Rider. “If your loved one asks your opinion, offer it supportively, otherwise, find other ways to be a positive presence.” 

When someone is first diagnosed, it can be easy to want to help them with everything and overcommit.  “Only agree to things you know you’re able to provide,” says Rider. “If your loved one relies on you for things you aren’t able to do consistently, this will cause them more stress, and stress can affect blood sugar levels.” 

When caring for someone with diabetes, it’s also important to continue taking care of yourself,” adds Rider. “You aren’t able to give to others when you aren’t at your best. Your goal is to provide love, care, and support to help them manage their condition and live an easier and healthier life with it.”

For more information on diabetes diagnosis, treatment and education, call the Endocrinology Center of SWLA at (337) 310-3670.