I am about ready to lose my mind about my mother! She is becoming increasingly forgetful, and I am concerned about her safety. She is forgetting to pay her bills and almost had her electricity turned off. She is also calling me constantly asking me the same questions over and over. Yesterday she called me at work wanting to know when I was coming over for dinner. I explained that I was coming over on Friday, not today. She called me up again one hour later with the exact same question. I want to help her, and I feel she needs to see a doctor and get someone to live with her. However, every time I bring up the subject she yells at me and tells me to mind my own business! I don’t know what to do. Please help. - Sue

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It is often difficult to ask for help. The most important time to ask for help, and often the most complicated time, is when you are a caregiver. It is normal to feel like you need to do everything yourself; as a society we place a high value on the unrealistic goal of doing it all alone. However, asking for help is not a sign of weakness or failure; it is instead an act of wisdom. After all, you’re not going to be your best as a caregiver when you end up tired, feeling resentful, hurt, and used.

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Adult children are the most common caregivers of the elderly. Caregivers whose childhood included domestic violence or emotional abuse face additional challenges in caring for elderly parents. Being in a role beyond their limits can be stressful for adults abused as children and can also put the senior at risk of neglect or outright abuse. An honest appraisal of the potential caregiver’s strengths and vulnerabilities can help prevent problems for everyone.

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Alzheimer’s disease (AD) poses a number of safety issues, especially if the senior is still at home. This article focuses on precautions you can take to make the home safer for a senior with AD.

If a senior with Alzheimer’s disease is still at home, the caregiver needs to follow all the usual safety precautions, such as having a working fire extinguisher and smoke alarms in the house; making sure that appliances and heaters are working properly; and keeping extra food, flashlights, and blankets on hand (in case of earthquakes, power outages, or other emergencies). However, there are additional precautions you may want to take to protect a senior with AD.

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You’ve probably heard that moving is one of the ten most stressful events in life, right up there with changing jobs, divorce, and death. If just moving within the community is stressful, imagine how much more difficult it is for elderly people confronted with moving into a care facility. Often this kind of move forces the senior to confront many challenges. Understanding these challenges can help a caregiver ease the senior’s burden.

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Caregiver “meltdown” results when caregivers don’t get the help they need and begin to suffer from depression and stress. Finding help will allow you to take care of yourself and your needs, and will prevent meltdown. Taking care of yourself also helps the person you care for because you will be a more patient and effective caregiver.

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Depression could be called “the illness with many faces.” Consider these examples:

• An 83-year-old gentleman becomes very agitated, pacing back and forth and snapping at anyone who approaches him. He repeatedly talks about the end of the world and the doom of the human race. Although he says he feels tired, sleep seems to elude him, and his pacing continues into the early morning hours. His weight has dropped rapidly.
• Martha, a 78-year-old retired teacher, has slowly started to withdraw from her friends. The clubs and hobbies she once enjoyed no longer hold her attention; rather, she sits in her rocking chair, staring blankly out the window. Although not seeming particularly sad, she does not express pleasure or curiosity. It’s easy to forget her presence, as she seldom verbalizes any needs.
• When Sam’s wife died three years ago, he was very calm. Her caretaker during a long, lingering illness, this 90-year-old minister seemed prepared for her death. However, with no apparent precipitant, Sam has now begun crying many times a day, sometimes sobbing in despair. He has difficulty articulating what is wrong and seems unable to control his tears.
• Clara is 72 and feels she is near death. She describes a vast number of physical problems, all vague and variable. Her bedside table is covered with medications and medical paraphernalia. Because of long hours of bedrest and snacking, her weight has ballooned. Clara’s primary physician, frustrated, avoids her calls. Yet Clara’s obsession with her health only seems to grow.

These cases seem quite different but are all faces of geriatric depression, an illness that affects quality of life and may lead to premature death in older adults. How do we, as caregivers, recognize the signs of depression? Even more importantly, how can we assist in its treatment?

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Shock, disbelief, despair, anger, depression, and relief are some of the reactions you can expect to feel when someone important to you dies or even when a relationship ends. The extent and duration of grief can vary greatly depending on the nature of the relationship and the circumstances that ended the relationship, such as death, divorce, or breaking up. The severity of the grief felt by survivors can vary depending on how close they were to the deceased and whether they perceive that the death occurred prematurely. For example, a child who provided constant care to an ailing parent is likely to feel more intense grief than a more distant relative who did not participate in the day-to-day care.

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Second Wind, by Neil Shulman, and P. K. Belville, published by Rx Humor, 1995, is inspired by the real-life experiences of the authors, both of whom have hands-on experience in geriatric care. This novel about a fictitious nursing home in small-town Georgia brings its characters to life in the humorous but touching story of a facility trying to stay open despite financial hardships. For the most part, plot is secondary to character development and painting a rosy picture of life in a nursing home. The book is primarily a series of character sketches interspersed with moments of high drama, sidesplitting comedy, and the occasional tragedy or near tragedy.

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