Dementias are brain diseases in which memory, judgment, attention and learning are seriously and progressively challenged. Alzheimer’s disease (AD) is one form of dementia in which the challenges are never ultimately won.
In light of the multiple symptoms associated with AD and their similarities with other health problems, AD is not easily diagnosed. In other words, some of the symptoms of AD also are commonplace in depression, adverse drug reactions, nutritional deficiencies, strokes, head injuries and other potentially reversible conditions.
Numerous evaluative criteria (complete health history, CT Scan, EEG, blood studies, urinalysis, cerebrospinal fluid and more) should also be included for a more likely accurate diagnosis of AD. In fact, the only way to secure a 100% accurate diagnosis is through an autopsy.
Causes
The causes of AD are many and controversial.
The economic impact of AD is astronomical and increasing. The cure for AD does not yet knowingly exist.
These noted concerns, however, actually fall outside the boundaries of this article. Rather, attention is here focused on suggestions as to how best to provide accurate and appropriate care to AD victims.
These suggestions are the result of my consultations with a former caregiver and employee of the Alzheimer’s Association of Central Alabama in Birmingham, Alabama. These suggestions also result from the observations and interactions with one of my own sisters who recently died from AD complications.
Say this, not this
Don’t reason (or argue) with AD victims. For example, if they say, “What doctor’s appointment? There’s nothing wrong with me,” don’t reason by saying, “You’ve been seeing the doctor every three months for the past two years. It’s written on the calendar and I told you about it yesterday and this morning.” Rather, simply say, “It’s just a regular check-up,” or “I’m sorry if I forgot to tell you,” or “Would you like to stop and get an ice cream cone or coke before we see the doctor?”
Don’t confront AD victims. For example, if they say, “Nobody’s going to tell me what to do or make decisions for me. Why don’t you leave me alone and not come back,” … simply say, “I’m sorry that this is a tough time for you, but I love you and we are going to get through this together,” or “You know what? Don has a new job and is really excited about it,” or “Have I told you today how pleasant the temperature is outside.”
Don’t remind them that they forget all the time. For example, if they say, “Joe hasn’t called for a long time, I hope he’s OK,” don’t say, “Joe just called yesterday and you talked with him for 15 minutes.” Rather, simply say, “You really like talking with Joe, don’t you,” or “Let’s call him when we get back from our walk.”
Don’t question recent memory. For example, if they say, “Hello, Susie, I see you have brought a friend with you,” don’t say, “Oh mother, this is Betty, don’t you remember any thing?” Rather, simply say, “Hi, Mom. You look wonderful today. This is my friend, Betty. She and I work together. She is a wonderful person — just like you.”
Don’t take it personally. For example, if they say, “Who are you? Where is my husband?” don’t say, “What do you mean? I am your husband.” Rather, simply say, “He’ll be here for dinner,” or “How about some milk and cookies?”
The essence of these directives is that caregivers should give short explanations, repeat comments exactly, allow plenty of time for understanding, and avoid being confrontational.
Graciousness and generosity
To either agree with them or distract them is very important. To either accept blame or just leave the room may also be appropriate. Graciousness and generosity should also rate high on one’s response list.
It is important to remember that they are not lazy or crazy. Whatever they are saying or doing is simply par for the course for AD victims. Even though some days they may seem normal, their perception of reality is very different from those who care for them.
Also, they are typically scared all the time. The anxiety associated with this state of mind may reveal itself through anger and hostility or extreme passivity and uncooperativeness.
They are seeking to protect themselves. Since caregivers cannot control the thoughts and actions of AD victims, controlling one’s own thoughts and actions must be paramount.
Additional considerations:
(1) staying familiar with the family so you won’t be lost as the condition worsens;
(2) having pertinent information on what to expect as the condition worsens;
(3) periodically ride the caregivers around;
(4) rotate caregiving helpers to reduce burnout;
(5) contact Meals on Wheels, provided by the Community Action Agency, which brings food for homebound older people at low cost;
(6) put plastic covers on the bedroom floor;
(7) lock the bedroom doors;
(8) use wall monitors to listen to activities;
(9) keep the family updated on what is going on in the community;
(10) be aware of potential violent tendencies by the AD victim;
(11) AD victims have no awareness of personal hygiene;
(12) AD victims are typically very sensitive to noise and bright lights.
Of special note is how churches may respond to the needs of AD caregivers:
(1) Provide opportunities for the observance of the Lord’s Supper at their residences. The symbolic meaning of this observance could serve as a real source of encouragement and participation for those care givers whose absence from regular church service observances may be necessary due to the demands of caregiving.
(2) Prayer should not only be made for the victims and caregivers but also with the victims and caregivers at their residences.
(3) Be aware that some caregivers may be reluctant to ask for help due to either embarrassment or pride. So, rather than trying to help them without asking, find out somehow what kind of assistance may be needed.
(4) Obtain legal advice from informed people (lawyers or denominational offices) as to potential liability concerns. After all, liability matters are of utmost importance in this day and society.
While these ideas are not intended as the one and only ways to deal effectively with the task of caregiving for AD victims, they hopefully provide readers with insights which may be adapted according to one’s own specific situation (people, settings, time, etc.).
The purpose of this paper is not to make extravagant claims about how the Christian faith or church may resolve all health challenges which people face with regard to Alzheimer’s disease. After all, even Christians are subject to any number of health problems which all members of the human race typically face.
EDITOR’S NOTE — This is an excerpt of an article written by Morris Murray Jr. of Jasper, Alabama. Murray is a health care management specialist, former college and seminary professor, former pastor of churches in Alabama, Louisiana and Texas. He is presently an associate pastor/minister of music and outreach at Samaria Baptist Church, Jasper.
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