Caregiving: Help for the Holidays
What every caregiver needs to know for a smooth holiday season.
Reviewed By Brunilda Nazario
On top of the cookie baking, decoration hanging, eggnog beating, and hunting for presents -- if you are responsible for the care of another person, the holidays can present some special challenges.
Caregiving, of course, is not confined to taking care of a person in the home setting. "Caregiving is caregiving," Gary Barg, author of The Fearless Caregiver: How to Get the Best Care for Your Loved One and Still Have a Life of Your Own, tells WebMD. "Caregiving is about 15% dealing with the disease or disorder and the rest about dealing with the stress."
One of the biggest misnomers, he says, is that if your loved one is in a facility, you are no longer a caregiver. "You are!" he insists. Besides being a writer and editor for Caregiver magazine, Barg has cared for several disabled relatives over extended periods.
De-stressing the Home Setting
If someone in the house is in a wheelchair, unsteady on his or her feet, or cannot make good judgments or be left alone, it is important to keep decorations low-key.
"Visitors should be invited one at a time [in the case of demented loved ones]," Myron Weiner, MD, professor of psychiatry and of the Alzheimer's Disease Center at University of Texas Southwestern Medical Center in Dallas, tells WebMD. "Maybe a son, daughter-in-law, and one quiet child at a time is alright." He doesn't recommend the whole extended family descend, however. "This can make some patients agitated or withdrawn," he says.
The Alzheimer's Association of Los Angeles recommends forewarning relatives about a loved one's present condition, perhaps with a letter saying the person has changed, has problems thinking clearly, and will respond well to a warm touch.
"I don't think you need to do that," Weiner responds. In fact, he says, people with Alzheimer's tend to preserve their social graces, making bland and appropriate remarks. "People who don't see the person often may not even think there is that much wrong," he says.
You don't need to make a big deal of it. If there is a toileting accident, take care of it as you normally would. "And keep visits short," Weiner says. "Two hours, perhaps, but not five hours."
De-stressing the Caregiver
"We believe in the reverse gift list," Barg says. The caregiver should realize he or she is the CEO of "Taking Care of Momma, Inc.," he says. Like any CEO, that caregiver has to delegate. "We don't have to shoulder the whole burden," he says. When people do come to the house, it's the caregiver's turn to delegate some tasks.
And, Barg says, don't forget catering. You may not need to prepare an elaborate meal if you don't want to.
Holiday time naturally means some big family meals. "Don't even begin to think the ill person is going to prepare the meal or even do the menu," Weiner says. But do involve the person in simple helping, such as peeling veggies or setting the table (if they did such things before the problems began).
In a crowded situation, Barg says, don't play handoff. Be sure you as the primary caregiver knows where the person is and if they need anything. Some patients wander and this is the perfect time for them to slip out the door.
You have to know the person and what they enjoy -- or don't enjoy. Some people with brain impairment will cuddle a baby for hours, Weiner says. With others, this would be a bad idea.
As for gifts, Weiner suggests sensual things, scented soaps, or sachets. Perhaps tapes or CDs would be appreciated, or photographs in frames.
He also recommends making conversation about the past, if the person has a brain function problem. "Get them to retell their old stories," he recommends.
It is also important to maintain the person's regular sleep patterns and not let the patient get too tired. This goes for the caregiver, too!
And most important of all? "Make sure the person sees love all around." Weiner suggests having mistletoe (the nonpoisonous artificial kind) to keep the kisses coming.
Sometimes, Barg says, holidays loom large because people think it might be the last holiday with the person. Maybe yes, maybe no. Your loved one knows you are doing your best for them. One day at a time.
One caregiver Barg knew said he was always hoping. "I hope she will not be incontinent. I hope she will not make weird noises," he tells WebMD.
"Then," the man told Barg, "it suddenly dawned on him. I need to hope less and care more."
"It's not about the perfect turkey," Barg says, "it's about the love."
Star Lawrence is a medical journalist based in the Phoenix area.
Published Nov. 19, 2004.
SOURCES: Gary Barg, author, The Fearless Caregiver: How to Get the Best Care for Your Loved one and Still Have a Life of Your Own; and editor, Caregiver Magazine. Myron Weiner, MD, professor of psychiatry; and director; Alzheimer's Disease Center, University of Texas Southwestern Medical Center, Dallas. Alzheimer's Association web site.
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