AGING IN AGONY

YOU REALLY SHOULD KNOW WHAT IT FEELS LIKE TO GROW OLD  

TREAT OLDER PEOPLE WITH EMPATHY AND KINDNESS

Sharing with you the following extracts from the articles, Titled Aging in Agony on Elder Abuse and What does it feel like to grow old?, by S Indramalar in Star2 on 11 March 2016.

With his shoulders slumped, head hanging low and chin resting on his chest, Bernard Matthews is a shell of the man he used to be.

Up until a few years ago, the 82-year-old retired teacher used to read and write. A strapping man – he used to play hockey in his youth – Bernard would walk to the neighbourhood coffee shop to discuss current affairs and exchange “war stories” with his friends.

These days, he doesn’t say much. He shuffles and mumbles, and prefers to stay in his room.

He was recently diagnosed with depression and dementia, but his well-being deteriorated rapidly because he has been mistreated at home.

The verbal and emotional abuse started four years ago.

After Bernard lost his wife, his son and family moved in with him. Bernard thought their company would be good in his golden years.

He didn’t expect to be bullied.

It was his house but Bernard was made to feel like he was invading “their” space. He was yelled at for every little thing: forgetting to turn the TV off, not folding his towel or even watching “too much” television. He was accused of being a “burden” even though most of his pension went towards household expenses, called a “nuisance” and was constantly belittled.

All this began to eat away at Bernard. Bit by bit, he became withdrawn and depressed. He stopped going for his walks.

A concerned neighbour alerted the police and two officers came to check on him in his house in Labu, Johor. After assessing the situation, one of them discreetly advised Bernard to file a report of abuse.

For the first time, Bernard felt he could do something about his situation. He called his daughter who lived in Kuala Lumpur and they went to the police station where Bernard shared about the abuse he’d been suffering.

The police said they’d help him get a protection order from the courts. But at the last minute, Bernard backed down.

“He is my son. I don’t know why he is like this but he’s my son,” Bernard told his daughter. He also refused to move in with her because he didn’t want to leave his own house.

Elder abuse is a growing problem in Malaysia’s fast-ageing society but it is a crime that is grossly under-reported. Just like domestic violence, most view it as a “family matter” that is best dealt within the family.

Elder abuse, as defined by the World Health Organisation, is a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.

The country also needs to re-examine its laws to ensure the elderly are not vulnerable to abuse.

Thus far, the assumption is that the elderly will be well cared for in their golden years because filial piety is a trait most Malaysians are brought up with.

It is, however, not a value everyone subscribes to. The hard reality is that government health and social services must play their roles in protecting the elderly from abuse or mistreatment. Presently, there are no specific laws to ensure elderly care, what more protect the elderly from abuse. The welfare of elders comes under the purview of the Penal code and the Domestic Violence Act.

Doctors, social workers and other frontline responders now do not have clear guidelines on handling elder abuse.

“We found that most primary care doctors and nurses have had no training on handling elder abuse cases and rely on the guidelines that we have on child protection. Without any clear guidelines when it comes to elder abuse, most said they were just guessing and didn’t know what they should do,” says Universiti Malaya’s Department of Social and Preventive Medicine lecturer Assoc. Prof. Dr Noran Naqiah Hairi. She is leading an ongoing study – called the Prevent Elder Abuse and Neglect Initiative (Peace) – with her colleague Dr Clare Choo.

Consultant Geriatrician, Dr Rajbans Singh concurs, pointing out instances when social workers wanted to remove the elderly from an abusive environment but had nowhere to place them.

“So, what do doctors do? Do we call the police? We are not clear on the protocol related to elder abuse. When it comes to children, the SOPs are clear as we have the Child Act, but not so with elderly patients."

“At present, what we do is talk to the family members and try to counsel the caregivers and discuss problems they may face,” he says.

He stresses that while we may want to believe that as an Asian society we will look after our elderly, we need to accept our changing society and prepare for the future.

One of the contributing factors to elder abuse cases, says consultant geriatrician Dr Rajbans Singh, is a lack of awareness, knowledge and understanding about elderly care and support.

“In my 20 years as a geriatrician, I have come across many cases. A lot of the times, the abuse occurs not because the carers or family want to intentionally hurt or harm the older person but because they do not know how to care for the elderly."

“It’s different with children, where you are in charge and you can set the rules. With the elderly, they can make up their own minds. We have to remember that these older people were once ‘somebodies’ – they were the head of households, they were professionals or had jobs and were depended on for many things. But, the roles have now changed and that’s not an easy thing to deal with,” explains Dr Rajbans.

"Things get more challenging if the older person is no longer alert because of Alzheimer’s or dementia, diseases that correspond largely to ageing."

“Emotional and psychological abuse is very common especially if the patient (older person) has dementia. Many carers really don’t understand the nature of the disease and don’t know how to deal with someone with dementia,” says Dr Rajbans.

He shares his childhood experience of dealing with the elderly.

“My grandfather had dementia. At the time, I was quite young… I wasn’t a doctor yet. He would just walk out and talk about things that didn’t make sense to us. Sometimes, he would go to the road outside our house and take a leak. I remember my cousins would get very upset with him. They took his actions personally, as if the old man was out to make things difficult for them on purpose.

“What we didn’t understand at the time was that he was suffering from dementia. It was only years later when I became a doctor did I understand his behaviour at the time,” he shares.

"However, as important as it is for caregivers to empathise, it is also crucial for them to have a support system to lean on."

“Most families think about the welfare of the older person so much, they forget about the carer. In many families, the responsibility of caring for the older person falls on the shoulders of one child or one sibling."

“The others may contribute financially or occasionally, but the responsibility is largely on one person. It can take a heavy toll, especially if the elderly person is not well."

“The carer’s life now is centred around this older person. After some time, with no support or help, he or she may find it hard to cope and that is when the abuse starts – by taking out the stress on the elderly person,” says Dr Rajbans.

When it comes to caring for the elderly, families need to come together and support each other.

“If it gets too stressful, caregivers can hire private nursing help for a few hours every week just to allow them some time to do their own thing. Or, find suitable day-care facilities that are comfortable for the elder persons and allow them to meet and talk to their peers, while giving caregivers some time for themselves,” suggests Dr Rajbans

Presently, senior citizens (60 and above) make up 9% (2.77 million) of the country’s 30.49 million population. This figure is expected to shoot up to 15% by 2030.

The existing support services aren’t enough to cope with the current ageing population, let alone the surge in less than 15 years.

Something needs to be done, says Consultant Geriatrician, Dr Rajbans Singh.

“We currently have 20 geriatricians in the country. Singapore has a much smaller population and they have about 100. In many countries, geriatrics has become one of the largest (area of) specialisation as they know they are dealing with an aging population. We need to catch up,” he says.

“An ageing society is our reality. Everyone is busy with their careers or living abroad. We have to think of putting in place support services – community nursing homes and day-care centres, community nurses and so on. “It’s not too late, but we have to act quickly,” he says

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(Full Text – star2@thestar.com.my, 11 March 2016)

ASHLEY CAMPBELL OPENS UP ABOUT ALZHEIMER’S AND A DAUGHTER'S LOVE

Ashley Campbell vividly remembers the day when she first began to notice the changes in her father, country music legend, Glen Campbell.

She was in high school and had invited her friends over to watch a movie - Lord of the Rings. Her father poked his head in, mid-film, to say hello and inquire about what they were watching. Ashley told him and he left.

He came back several minutes later, asking the same question and receiving the same answer.  The scenario then repeated itself for a third time.

As she recalls the episode, Ashley, now 26, admits initially attributing her father's behavior to his characteristic unconventionality. "My dad's always been a little eccentric," she says, her voice tinged with deep affection. "I didn't think much of it, at the time."

Eccentricity has long been considered the purview of the highly-creative. And Glen, an actor, former television show host, and six-time Grammy winner, certainly fits the bill.

Unfortunately, it wasn't the crooner's creativity that was driving this new behavior.

Though the Campbell's didn't know it at the time, Glen was beginning to show signs of dementia - Alzheimer's disease, to be exact - a degenerative brain condition hallmarked by memory loss, confusion and hallucinations.

The show must go on

Glen received an official Alzheimer's diagnosis in early 2011. He and his family chose to go public about his condition later on that year.

Ashley says she was too young to have been involved in the family's decision to announce her father's diagnosis (and thus, brave the staggering stigma that surrounds Alzheimer's disease). But she states that the choice wasn't a difficult one for her parents to make, given that Glen was continuing to record and planned on touring at least one more time. "He was still performing and we didn't want people to attribute any of his behavior to drugs," Ashley says.

Glen showed few public signs of slowing down as he embarked on his farewell tour and released a new album, entitled: "Ghost on the Canvas."

Ashley, a budding musician in her own right, got to accompany Glen on his final tour - which ended in December 2011.

During the tour, Ashley, her brother, Shannon, and their band, "Victoria Ghost," opened for Glen. Once the "Rhinestone Cowboy" took to the stage, Ashley could be seen standing just to the side of her father, her fingers deftly picking on a banjo, or flying across the keys of a keyboard as part of his backup band.

She says that the experience was invaluable, both personally and professionally.

"I can't even put it into words how priceless it was for me to be able to perform with my dad. It was a ridiculously valuable experience for me as a performer. But, more importantly, it was so great to watch my dad doing what he loves. Being able to witness the legacy he created and to see all of the fans who love and support him - being caught in that crossfire of encouragement was amazing," she says.

Her presence also served as an anchor for Glen, whenever he flubbed a note, or lost track of what songs he'd already played. During these rare instances, Ashley was ready to step in and diffuse the tension, gently guiding her father back on track, whenever he lost his way.

She also acted as a stand-in spokesperson for her father whenever he would step into the public eye. It is a role that Ashley seems uniquely suited for, which makes it even more amazing when she admits that she fell into it naturally. "It wasn't really a conscious decision. It's just my way of being supportive of him and productive at the same time," she says.

Ashley's mother, Kim, is Glen's other rock.

Kim acts as Glen's primary caregiver and Ashley moved back in with her parents several years ago to help out. Together, the two of them form a formidable team, each filling in whenever they're needed. "She leans on me, I lean on her, we lean on each other," says Ashley. "No one can do this alone."

A different kind of legacy

The Campbell's decision to tell the world about Glen's struggle with Alzheimer's, combined with their unwavering support has enabled Glen to be transformed into a generational icon of a much different kind than he's used to being.

Glen's candor, combined with his dogged determination to continue to pursue a lifelong passion of performing, seems to have converted him from pop culture icon, into a symbol of the baby boomer generation's ongoing fight against the stark realities of a disease that has no cure and no truly effective form of treatment.

It's this last truth - the lack of a functional cure for Alzheimer's - that the Campbell's are banding together to help change.

Like many newly-anointed caregivers, Ashley and her family initially had no idea of the scope of the Alzheimer's epidemic, nor the size of the community of people caring for loved ones with the disease.

"After the announcement, there was this amazing outpouring of support from the fans and their families," she says. "Meeting so many people who were affected by the disease was a huge incentive for us to become advocates."

Glen, Kim and Ashley all recently traveled to Washington D.C., where Ashley gave a moving testimony about her father's struggles with Alzheimer's to the Senate Special Committee on Aging. During her oration, she stressed the need to funnel funds into finding a remedy for the disease.

With her parents sitting nearby, Ashley spoke frankly of Alzheimer's effect on her father's memories.

"Now, when I play banjo with my dad, it's getting harder for him to follow along and it's going to get harder for him to recall my name," she says, her voice breaking a bit as she admits the blunt truth about what the future might hold, "It's hard to come to the realization that someday my dad might look at me and I will be absolutely nothing to him."

In those moments, it seems as though Ashley herself serves as a stand-in for every person who has ever had to witness a loved one slowly succumb to the effects of Alzheimer's.

When asked if shouldering such a heavy burden of responsibility is difficult, given her young age, Ashley politely demurs. "You kind of learn to take each day as it comes. It's a lot easier to do something like this when it's for someone you love. It's not hard - it's an honor."

Coping by coming together

As hard as the journey ahead is likely to be, Ashley and the rest of her family aim to make the most out of the time they have left with their beloved patriarch.

"Obviously it would be better if he didn't have it," she says of her father's condition. "But, it helps to try and put a positive spin on something you can't change. I've gotten to spend so much time with him since we started touring together. I've learned not to take any moment for granted. To me, he's not just an amazing musician - he's an incredible dad. Thankfully, I've gotten to spend time with both."

Indeed, Ashley was there when Glen received his Lifetime Achievement Award at the 2012 Grammy's. She's performed with him in front of thousands, played duets with him in the privacy of their home, and she's pledged to be there for him, until the end.

When asked what she would say to the countless men and women caring for family members with Alzheimer's, Ashley Campbell recites the most important (and most often overlooked) tenant of the caregiver credo: "Don't ever think that you should, or could, do this alone. You have to find a support system because there are times when you can't do anything but lean on one another. No one should have to go through this alone."

(Source: AgingCare.com, 4 June 2013)

Reminder To Filial Son Moves Others To Care For Their Aged Parents

(Source, The Sunday Star, By Yvonne Lim, yvonnelim@thestar.com.my, 12 May 2012)
 Nobody visits the Leong car air-conditioning service shop here without learning a thing or two about filial piety.

And not many leave without shedding a tear or two after reading a framed “Letter from Mom” with its reminder of a child's duty to his aged parents.

The letter taking pride of place in the shop of 60-year-old Leong Swee Kee reads in part:

“My Child, when I get old, I hope you understand and have patience with me."

Cherished possession: Leong showing a family photo which includes his late mother (middle, in grey)-RONNIE CHIN/The Star
“When my knees get weaker I hope you have the patience to help me get up."

“Like how I used to help while you were little."

“Do you remember learning how to walk?”

Leong said the “letter” was put together by his sister-in-law in memory of his mother, Chung Thye, who died last year at age 103.

“She had a stroke in 1997 which left her barely able to function on her own. My five brothers and I took care of her until she died in May last year,” he said, nodding towards pictures of his mother which adorn the wall.He added: “Those who have cared for a stroke patient understand the challenges. Many times, people came up to me and asked why I did not put my mother in an old folks' home since caring for her at home was so troublesome?

“I told them that my mother had worked hard and sacrificed so much to raise my four brothers and me single-handedly after our father passed away when I was seven. It was an honour for us to take care of her in her old age.”

Leong described his mother as “generous and giving”, and said that many of his customers remembered her as the old lady who would serve them boiled sugarcane juice while they waited for their car to be serviced.

“She cared more about what she could do for others than what they could do for her,” he said.

Watch Video ->  Letter from Mom

The father of two grown-up children said he put up the “letter” in his shop to remind customers, especially young people, the importance of caring for their parents.

“Some customers cry after reading it. One man came up to me weeping. He said he was taking care of his own father who suffered a stroke recently and the letter had encouraged him greatly,” he said.

Leong believed that he and his brothers had by example taught their children the meaning of filial piety.

“It is a good feeling to know that I was a good son to my mother. It has been a year since she passed away, and I still miss her a lot,” he said.

“But I am happy to know that she lived a rich, long life with the people she loved and who loved her in return.”

Who Is Worse Off: People With Alzheimer’s OR Their Caregivers?

Though they look through the prism of the future from different angles, people with Alzheimer's disease and their loved ones will likely find their lives dramatically altered after the onset and diagnosis of AD.

Certainly, the person who develops the disease is facing a life-altering and ultimately terminal disease. However, because of the intensive care needed by people with advanced Alzheimer's, and the pain involved in watching a loved one gradually lose their cognitive abilities, some people wonder if the caregivers endure more than the person with the disease.

Every case of Alzheimer's disease is as unique as the individual with the disease, and every caregiver brings unique traits to their caregiving journey. Each configuration, also, has different resources, different support systems and different coping skills. Thus, there is no one answer, and if there were the answer would likely change, depending on the challenges of any particular day.

A Quick Look At The Alzheimer's Journey From Inside

At this time, Alzheimer's disease is considered incurable. People who develop AD tend to die from seven to 10 years after diagnosis, though some can live as long as 20 years. Still, upon diagnosis, the person diagnosed knows instantly that his or her life is going to change dramatically.

Though testimonies from people with AD illustrate that many people with dementia continue to enjoy life for a number of years, there is no denying that their life will change dramatically, over time.
   
The person with AD must come to terms with the fact that as time moves forward, he or she is likely to lose the ability to live independently. Worse for many people, is the realization that one's memories and ability to reason will likely be stripped away. Their feeling of dignity as a human being is subject to being altered, as well.

Most people like feeling as though they have some control over their lives. The person with Alzheimer's lives in a world that is increasingly confusing, and often frightening, as the stages of the disease move forward. Making sense of one's surroundings becomes nearly impossible.
   
Paranoia is an understandable development in many people with Alzheimer's. When the brain tells a person one thing and everyone around this person is saying the opposite, it would be natural to wonder if people are playing tricks on them, lying to them or even stealing from them. Paranoid behavior in AD is quite common and causes great pain to both the person with the disease and the caregiver.

People with the disease generally become completely dependent on others, which is hard enough for most people. However, with AD, the person will likely lose the ability to remember who their caregivers are from moment to moment. Spouse, child, grandchild? Eventually, only the feeling of being dependent on a complete stranger may remain.

The Caregiver's Journey

Caring for a person with Alzheimer's is intensive and stressful, and it can be all-encompassing. After a loved one is diagnosed with Alzheimer's disease people generally suffer through an agonizing period of grief. It seems impossible to accept the fact that their spouse or parent has a disease that will rob him or her of personality, memories and the ability for self care. Yet, there is no alternative but to accept the diagnosis and move forward.

One of the first things most people do after the diagnosis is to plan for the inevitable changes Alzheimer's brings. However, with Alzheimer's there are many variables. Some people do quite well for months or even years. Others will decline quickly. Yet, the family must try to look ahead at the changes that will most likely occur, and plan with their loved one how best to manage the disease and future care.
   
With AD, people can change moods in an instant. The caregiver may be constantly on edge, worrying about mood swings, incontinence issues or the person wandering away and getting lost. Some people with AD have significant personality changes, which is distressing to loved ones.
  
Watching the slow process of Alzheimer's rob a loved one of memories and abilities can be excruciating. People who love and care for someone with Alzheimer's disease face the daily task of accepting the losses their spouse or parent must endure, all the while knowing that at the end of this journey they will suffer the second loss of their loved one through death.
   
The paranoia that often accompanies Alzheimer's can turn the diagnosed person against his or her caregiver, leaving the caregiver feeling helpless and ineffective.

 Alzheimer's disease is progressive and there is a downward spiral through recognized stages, however that doesn't mean the disease leads down a straight path. This uncertainty can contribute to the caregiver feeling uniquely alone and isolated, even when support services are offered.

Considering the challenges that people with Alzheimer's disease and their caregivers face, is there any joy at all in the journey? For many, yes. Caregivers can and do find joy in caring for someone they love, even if exhaustion and occasional impatience can make them wonder how long they can continue this intensive care. Most people eventually need to include paid outside help.

As for the person with Alzheimer's, many find a new determination after the diagnosis to live each day as fully as possible. They are aware of the changes that loom in their future, which makes the present more precious.

Who has a more difficult time? I believe that question is like most other quality of life questions. The attitude of the people involved, as well as their resilience, their flexibility and ability to accept what life hands them, will make the answer to this question unique for every Alzheimer's family.

(Source:  By Author, Columnist and Speaker, Carol Bradley Bursack, Agingcare.com, April 2012)

CARING FOR A MEMORY-IMPAIRED PARENT

(By Professor Dr Philip Poi Jun Hua, Consultant Geriatrician from University Hospital-UMMC, Malaysia & ADFM Panel of Medical Advisers)

THERE are an estimated 50,000 to 60,000 people with significant memory impairment in Malaysia. As a result, there is a silent, unrecognized band of Malaysians – mostly women (daughters) – who have chosen to take care of a loved one with such a condition, e.g. Alzheimer’s disease. This is a demanding job in itself, but many are not only care-giving. They are also raising their own children – and maybe working – at the same time.

For anyone in this situation, squeezed between the responsibilities of parent and caregiver, days are spent preparing lunches and making sure medications are taken, checking homework, and filling out health insurance forms. For the caregiver, his or her marriage, family, career, and health will be tested.

Being a caregiver does just mean taking care of a loved one 24 hours a day. If you are helping a parent out with the basics of living, and your visits have stopped being social and become a necessity, you have become a caregiver.

Taking care of someone with Alzheimer’s is too much for one person. You’ll need caregiver support from your spouse, siblings, doctors, local and national organizations; and of anyone else who offers it.

The Long Haul

There are seven things you need to accept about your future as a caregiver.

Your loved one may live for many years. The life expectancy of someone with Alzheimer’s depends on the age at which the diagnosis was made. Many people with Alzheimer’s disease live eight, 10, or more years. Becoming a caregiver is a serious, long-term commitment.

The demands of care-giving will increase. As the disease progresses, your loved one will need more and more help. In the early stages of the disease, caregivers spend about 14 hours a week on average caring for the person. In the advanced stages, it becomes a full-time job.

Being an Alzheimer’s caregiver will affect your family. There may be ways to get your children involved that will not only give you, the caregiver, support, but will benefit your loved one and transfer the care ethic to your children.

Care-giving will affect your finances. This is usually due to the cost of medications and the need to have an extra hand in the form of domestic help or a nurse.

Do not try to do it alone. Taking care of someone with Alzheimer’s is too much for one person. You’ll need caregiver support from your spouse, siblings, doctors, local and national organizations – and from anyone else who offers it.

Care-giving requires skills. Caring for someone with Alzheimer’s disease does not come naturally any more than lecturing on physics comes naturally. Care-giving for someone with dementia is not like looking after another child. Sometimes the logical, natural thing to do is the wrong thing.

The common problems faced by children looking after parents with memory impairment are usually a result of a lack of information on how to handle this new situation. You need to learn about the disease, its treatment, and the legal and financial issues. Consult Alzheimer’s disease web sites (see below), books, health care professionals, and other caregivers. Do not try to muddle through on your own. Both parent and caregiver will suffer the consequences!

Dementia causes memory impairment, but in the early stages of this illness, the forgetfulness noted by both your parent and the family might be innocuous. Many children attempt to correct the mistakes the parent makes in the hope that it improves the memory of the event. Some become irritated by the repeated questions asked. It is useful and important to appreciate that the reality experienced by those with memory loss is not your reality. They may insist a long gone relative is still alive or that someone is stealing their money. By persistently insisting that they are wrong in their perception can cause your parent to suffer from a loss of confidence and experience distress and possibly depression.

One solution is to distract your loved one with another interesting activity or to bring them to another room where there are no triggering cues. Try not to confront or correct, but to diplomatically distract to avoid creating a drama.

Later in the illness, when your loved one becomes increasingly dependent on you, there is a tendency to assume control over all activities. Prompting your memory impaired parent to change his or her clothing, or to bathe or eat may be necessary. They may react to your attempts to help in a way that you might find inappropriate, or irritating. When your parent behaves erratically, look for possible triggers as listed below:

- Physical discomfort: They may have an infection, a headache, lack of sleep, a toothache, or even simple constipation that could affect even your behavior!

- Activity related: In the past, your parent might have been the queen of the kitchen, and because of her worsening memory, you fear that she might harm herself and bar her from accessing the kitchen. You might find that your loved one becomes increasingly agitated as mealtime approaches, and this could be her intrinsic desire to prepare food for the family.

Distracting her with another meaningful activity or involving her in the kitchen whilst monitoring her activity might reduce her feeling of helplessness. In a similar situation, cessation of driving may be very disturbing and has to be handled with care and tact.

- Intrinsic personality: Some parents have in the past, docile temperaments, and some may have fiery tempers. One should anticipate amplification of their past behavior if they experience distress.

- Depression: A common association, which may precede or follow the onset of memory loss and can present with agitated behavior or restlessness.

When you feel overwhelmed, it is easy to get locked into your habits, to keep doing things the same way even if they are not working. Try to keep some perspective and think of creative ways to get help. At the very least, reach out to some of the local and national organizations for Alzheimer’s caregiver support (see below)

Family Issues

Explain the situation to your children. The chances are that your children have already noticed that something is amiss. So explain that it is a disease that is making grandpa or grandma behave strangely – and that it is not contagious.

Involve your children. Young children can provide entertainment; older children can help out by doing more chores around the house. Your children might not like to do this, but sometimes circumstances give you little choice. And if the household functions better as a result of their help, everybody benefits.

Develop a plan of care. If possible, bring the family together for a meeting. Decide with the older person what the primary needs are, who can provide assistance and what community resources would help. Summarize your agreement in writing. Keep in mind that family difficulties are common. Involve your family and siblings in the decision making process as early as possible.

Discuss legal and financial issues. These topics may be difficult to talk about, but they help ensure that the older person maintains decision-making authority even when incapacitated. Pre-planning will also lessen family disagreements and protect family resources. Do not delay addressing this item.

Sometimes, exclude grandma. A person with Alzheimer’s tends to become the center of attention, which can leave children – and other adults – feeling overlooked. So although you might feel guilty about it, you need time away. A weekly dinner out with just your spouse and children to reconnect as a family might be all you need to recharge your batteries.

Taking Care of Yourself

If you want to keep taking care of your family and your loved one, you need to keep physically and mentally strong. You need to give yourself breaks. If you have siblings, make a deal where they take over for the weekend, or even for a longer period.

Getting other people to help out does not only help you, it gives you the opportunity to interact with your friends, go shopping, or just to get your hair done. So stay fit. Eat in moderation. Activity is the key for physical and mental health. Try to squeeze in 20-minute walks or have a home exercise programme.

Long-Distance Caregivers

If your mother lives in Penang and you are in Hong Kong or even Johor Baru, how do you help take care of her?

Get Organized: Take care of necessary paperwork. Find all legal, financial, and insurance documents, including birth and marriage certificates, wills, and power of attorney. Identify bank accounts, titles, sources of income and obligations, and all relevant insurance papers.

Review these documents for accuracy and update them if necessary. Store documents in a secure place such as a safe-deposit box or a fireproof box.

Identify your informal network. Ask for help from people in the older person’s community, such as relatives, neighbours, long-time family friends and members of religious, civic, and social organizations. Ask them to call you if they spot a problem.

Investigate travel alternatives. Be prepared to “care commute” for any emergencies. Investigate travel options in advance.

Finally, maintain good health, make time for yourself, set limits, and allow others to help. Remember that the person with memory impairment has a different reality and it is easier to be non-confrontational and develop the patience of an angel.

(Source: The Sunday Star, August 9, 2009 - http://thestar.com.my/health)