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Thursday, September 20, 2012

When Someone You Love Has Alzheimer's - Part 2


Yesterday my blog article When Someone You Love Has Alzheimer's - Part 1 discussed some basic information about Alzheimer's disease and the Alzheimer's Association as a resource for support and valuable information.  Today I would like to discuss how to navigate family dynamics when family members disagree about elder care issues involving a loved one.

Making Decisions for a Loved One with Alzheimer's:
Making decisions for a loved one who has Alzheimer's can be one of the most difficult things that you and your family will ever have to do.


First of all, to accept that a mother or father (or other relative) who was once an independent and capable person is no longer capable of making decisions for her or himself can be heart wrenching.  But even after you've accepted this, you and other family members might not agree about how to proceed.  This can quickly lead to family conflict and degenerate into warring factions in the family, adding to an already very difficult situation.

The Alzheimer's Association:  Alzheimer's Organization
As I mentioned yesterday, the Alzheimer's Association, can be a wonderful resource for general information, but they can't make personal decisions for you about your loved one.  That's up to you and your family.

Getting a Diagnosis:
As I mentioned yesterday, Alzheimer's can look like other medical conditions.  It's a "rule out" diagnosis and a good place to start is with your family doctor.  Often, your family doctor will refer your loved one to a neurologist.

Important Elder Care Decisions to Make:
Once you have a diagnosis of Alzheimer's and you've obtained basic information from the Alzheimer's Association, it's often helpful to get an objective professional evaluation about your loved one's specific needs:
  • Can s/he take care of daily activities of living (e.g., getting dressed, preparing meals, paying bills, etc). 
  • Is it safe for your loved one to live alone?
  • Is it safe for your loved one to continue to drive?
These are just some of the many questions that need to be addressed.

So, what do you and your family members do after your loved one is diagnosed with Alzheimer's?

Call a Family Meeting:
Rather than going it alone, I recommend calling a family meeting and discussing the important elder care issues that are involved when a family member has Alzheimer's.  Usually, an important decision is whether or not to involve the family member who has Alzheimer's.  A lot will depend on whether he or she is still capable of understanding what's going on.  If not, it might be more confusing than helpful to him or her.

Prepare for the Family Meeting:
Before the meeting, gather your thoughts and write down the main issues that need to be discussed.  You don't need to cover everything in one family meeting and, in fact, it can be overwhelming.  Unless the situation is urgent and you need to make immediate decisions, it might be better to plan a couple of meetings, if possible, so you don't wear yourself and others out by trying to do it all at once.

Stay Calm and Be Patient with Other Family Members:
Although this can be a very emotional time, especially if family members don't agree or if they're in denial about the Alzheimer's diagnosis, try to stay calm so you can listen to your family's concerns.  You might have overcome denial about your loved one's diagnosis, but it might take other family members a little longer to come around.  Try to be patient.

Get an Objective Professional Evaluation:
Once your loved one has been diagnosed with Alzheimer's by a medical doctor, you need to know what are his or her particular needs.  So, it's often very helpful to start with an objective professional evaluation about the particular needs of your loved one who has Alzheimer's.  Having an evaluation often helps families in the decision making process.

Consult with a Geriatric Social Worker:
Geriatric social workers evaluate the needs of a person with Alzheimer's disease.  They are trained to evaluate and make recommendations for the elderly.  You and your family can start by getting information through various geriatric social work websites, including:  http://caremanager.org.
  • Make sure that the geriatric social worker you choose is a licensed social worker who is certified in geriatric care.  
  • Ask questions when you call about the geriatric social worker's credentials, the fee, and what services s/he provides.  
  • Before you go for the consultation, prepare questions in advance so you're organized for the meeting and use the time most effectively.
  • The geriatric social worker can't make decisions for you.  He or she can only make recommendations after the evaluation, and then it's up to you and your family to make important elder care decisions.  
  • A geriatric social worker can also help you to navigate through the confusing, bureaucratic morass of the health care system, whether your loved one is able to stay at home and get a home health aide or whether s/he needs to be placed in a nursing home.  S/he might also be able to recommend an elder care attorney so you can get a durable power of attorney or handle other legal issues involved.
Take Care of Yourself Throughout this Process:
People who go through this process often don't realize how stressful and frustrating it can be, even when there isn't family conflict about how to proceed.  It's easy to neglect yourself during this time.  So, it's important to take extra good care of yourself by eating well, getting enough sleep, and having emotional support.

You're Not Alone:
When you're faced with these difficult decisions and, possibly, your own conflicting emotions, you can feel very alone.  But, as the population ages, there are thousands of people going through what you're going through now.  You're not alone.  If you're able to attend a support group through the Alzheimer's Association, you could benefit from one of these mutual support groups.

Get One-on-One Emotional Support in Therapy:
Many people find it helpful to get objective emotional support in their own therapy while they're going through this challenging time.  It can be helpful to be in your own therapy to sort out your feelings about what to do.  It's one thing to have an objective recommendation and to know logically what to do, but it's another thing to handle it emotionally.

This is obviously a huge topic, which can't be completely covered in one or two blog posts, but if you're currently going through a difficult time with someone who has Alzheimer's, I hope these blog posts have been helpful. 

I'm a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  I work with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (212) 726-1006.

Photo Credit:  Photo Pin















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