Caring for Adults With Memory and Cognitive Limitations

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At some point in our lives, many of us will most likely become caregivers, or perhaps even need one.

Acaregiver can perform a multitude of tasks to help someone with daily life activities, such as shopping, going to appointments, bathing, eating, dressing and paying bills. Many American families care for an adult struggling with brain impairment and cognitive limitations. Those who are cognitively impaired have trouble with issues such as memory, concentration, perception and reasoning skills. Cognitive impairment can be brought on by many issues, including stroke, brain injury, Parkinson’s disease, a brain tumor and dementia.

Cognitive limitations can greatly alter how a person thinks, acts and feels. Such changes can create unique challenges for the families and caregivers. People with moderate to severe cognitive impairment may require special care and supervision along with specialized communication techniques. Those who are cognitively impaired may have a variety of behavioral issues that can be challenging and frustrating for caregivers. The afflicted individual could have problems communicating, may exhibit aggressive or impulsive behavior, suffer from memory problems, lack motivation, execute poor judgment and so on. There will be good days and bad days; the journey requires caregivers to remain patient and compassionate and to keep a pretty good sense of humor to cope with these challenges. Most importantly, caregivers must remember the behaviors are caused by the disease, not the person.

Communication between the caregiver and the patient is crucial. This is where patience and simplicity come into play. Ask one question at a time; instead of asking, “Would you like to come over here and sit down and have a snack,” break the question down into parts: “Sit down here” and “I have a snack for you.”

A few simple steps can create a solid foundation of caregiving. While cognitive decline is common with age, certain types can be more concerning than others. Consider reaching out to a specialist who can address some of the patient’s thinking skills. Meet with your primary care doctor to decide if a referral to a neuropsychologist is needed. This is a licensed psychologist with specialized training in assessment and treatment of cognitive problems typically associated with dementia and other neurological issues.

Information is empowering, so educate yourself. Talk to doctors, health and social service professionals and even those who are facing similar challenges. Read books, study information online and familiarize yourself with all aspects of the disease causing the memory issues and cognitive impairment in your loved one.

Determine the needs of your loved one. In the beginning, she may only require assistance with tasks such as paying bills or grocery shopping, but as the disease progresses, the care required may extend to bathing, dressing and eating. The primary categories of care include personal, household, health, emotional and supervision.

Be sure to outline a plan of care, which will change as the disease progresses. If needed, enlist advice from a healthcare professional to establish this plan, making a strategy to provide the best possible care for your loved one and yourself. At the beginning, list what your loved one is currently capable of doing and then list areas he may need help with in the future. Determine sources of informal support help, such as siblings, family members and friends who are willing to step in as needed. Also establish a list of formal support services such as those offered by the community, paid home care workers and day programs.

Financial issues must be addressed. What can the patient afford if professional help is necessary? You may want to bring in an attorney or financial planner to assist; it may be uncomfortable, but it’s a necessary step to plan for continued care. A specialist in elder law can help you figure out if the patient is eligible for Medicaid or other low-cost services. At the same time, review legal documents your loved one may have that address her needs, desires and wishes for care.

Safety-proofing the home is a highly integral part of the caregiving plan. Take into consideration fire hazards, sharp objects, loose rugs, furniture, secure exits, poisons, clutter and other areas of physical concern.

Finally, as a caregiver, make it a point to take care of yourself. This includes getting regular medical and dental checkups, getting plenty of sleep, and eating nutritious meals. Take some time away to recharge and allow someone else to fill in for you. This may simply translate to going for a walk or enjoying lunch with a friend.

Organizations that provide information on aging include the National Institute on Aging, the National Council on Aging, The American Society on Aging, the Administration on Aging and the American Psychological Association. There are many resources available. This is not something you have to endure alone. ■

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