Alzheimer’s Disease and Other Dementias: Symptoms, Stages, and Communication Strategies Expanded ____
they asked Angela what was wrong. Initially she denied there was a problem, but then she broke down in tears, stating that she didn’t know what was happening. She then admitted that she didn’t know where her car was. Angela’s distress concerned her children, as she had always been active and independent, and she took great pride in her appearance. She’d never trusted doctors, but she had a PCP assigned by her Medicare Advantage plan. Angela’s children knew she needed help to get organized, see a doctor, and make a plan. Kayla decided to stay for two weeks to assist, but she knew her mother might not be able to continue living alone. While organizing Angela’s papers, her children found that she had long-term care insurance. With the support of her daughter, Angela saw a doctor, started various therapies, began taking medication, and was approved for a caregiver through the long-term care insurance. Her children found her car in another parking lot in the community. Since many people don’t live near their children, Angela’s situation is common. As caregivers, the following should be addressed. • Establish a relationship with the primary care physician, who will make recommendations for specialists. • Identify appropriate specialists and make appointments. • Arrange and manage scheduling for appointments. • Gain insight into Angela’s financial situation and plan accordingly. • Ensure that long-term care planning documents are complete, including: ‒ Will ‒ Durable power of attorney ‒ Trust documents ‒ Healthcare surrogate ‒ Do Not Resuscitate ‒ Insurance policies ‒ Financial documents • Professional caregivers in this situation should establish a trusting relationship with Angela to ensure that she feels safe and comfortable. ‒ Establish a communication flow with her children. ‒ Create a structure around activities for Angela. ‒ Prepare a large visible calendar detailing activities and schedule. ‒ Engage in physical activity and mental stimulation. ‒ Engage Angela in menu planning and meal preparation. ‒ Continue to establish trust and a sense of safety.
CARING FOR THE CAREGIVER Caregivers can suffer from sadness; depression; stress; and feeling trapped, overwhelmed, and distressed (Shin & Haber- mann, 2022). Stressed caregivers may find their health compro- mised. It is important that family caregivers build a supportive network that will help them share the responsibility. Professional caregivers may also find the role stressful and as part of best practices, they should ensure that they are getting exercise, eating a healthy diet, having quiet moments, and reaching out for help as needed. New technology may be helpful for families and professional caregivers (Palmdorf, 2021). Devices include televisions, computers, smartphones, monitoring devices, fall prevention sensory devices, and robots. The goal is to provide supportive patient monitoring and engagement, caregiver connection, and telehealth. Health plans may offer these devices as part of their coverage, and all are designed to improve outcomes and well-being. CAREGIVER RESOURCES There are support resources for caregivers. The stress that a caregiver may experience is correlated to the amount of time they spend caregiving. Identifying ways to have meaningful support for the patient and the caregiver throughout each respective stage can greatly improve the overall well-being of everyone involved. Any caregiver may reach obtain informa- tion about local caregiver support resources, with the Veterans Administration National Caregiver Support Line by calling 1-855-260-3274. CASE STUDY #1: INSIGHT INTO FAMILY AND CAREGIVER BURDEN Angela, age 78, was a divorced, retired schoolteacher who recently purchased a home in a retirement community. She loves the unit and is friendly with her neighbors. She has two parking spaces in front of her place, and she shares one, since she only needs one space for her car. Angela is going to seeing her children—Kayla, age 42, and Trent, age 40—next weekend. Due to the pandemic, they haven’t been together for more than two years, though they do have weekly virtual calls. During a recent conversation Kayla noticed that Angela seemed confused, unfocused, and anxious. When she pointed this out, Angela became angry and defensive. Trent stated that he had not noticed anything different with his mother. Kayla decided she would address it again when they were together. When Kayla and Trent arrived at Angela’s, they noticed that her car was not parked in her space. Upon entering the home, they saw piles of papers and bags all over the living room. The always immaculate kitchen was filled with open boxes of partially eaten food, the coffee maker was filthy and cracked, and there was no fresh food in the refrigerator. They realized something was wrong. When they sat down,
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