-
Dr. Dionis Kononov -
Alt Text for Image
MORE THAN 6 MILLION AMERICANS are living with Alzheimer’s disease, and the broad majority—an estimated 80%—of those individuals are being cared for by family and friends.
While tending to someone suffering from Alzheimer’s or another form of dementia is a big responsibility, Dr. Dionis Kononov said there are a number of tactics people can employ to ensure they’re both keeping their loved one safe and looking out for their own mental wellbeing.
Kononov, a board-certified psychiatrist and medical director of senior behavioral health at The University of Toledo Medical Center, said one of the first steps for a caretaker is laying the groundwork for future needs.
That might include connecting with social services, establishing a power of attorney, or considering guardianship. It’s beneficial for caretakers to connect with the patient’s primary care physician and any specialists who are managing their dementia care, such as psychiatrists or neurologists, and they might want to consider engaging an occupational therapist to evaluate the patient’s home environment. “Really it depends on the individual’s family, depends on the individual’s decline in terms of what might be more appropriate, but all of these aspects have to be taken care of, especially earlier on before it gets more difficult to manage,” he said.
While it might be natural for caretakers to want to correct their loved one when they get something wrong, Kononov said that’s largely counterproductive and can set up conflict. “The reality of it is, if they are not able to recall what happened five minutes ago or are not able to recall the appointment times or where they were going, you’re not going to convince them otherwise,” he said. “You cannot make a part of their brain work that is no longer functioning. And so telling them your version of reality is the only true one and that whatever they are experiencing isn’t real is going to create distress and distrust. It’s going to alienate you from them.”
Instead, Kononov said, caregivers should follow a safety-first principle. If someone believes, for example, that they’re 10 years younger than they are and their deceased spouse is still living, correcting them is only going to create negative emotions. Someone doing something that could put themselves or others at risk does need to be addressed but, if possible, should be done gently. “Certainly if someone is wanting to go out into the snow with no clothes on, you need to maintain safety,” Kononov said. “However, trying to argue with an individual oftentimes is not going to be the route for this, and you may have to take more of a parental role of ‘this is what we have to do, I know you may not understand this at this time, but I am doing this for your own good and for your own safety.’” In general, Kononov said its best to maintain as much of a sense of autonomy as possible for individuals with dementia, particularly in the early stages as more and more tasks and activities become challenging or dangerous. “It’s a fine line,” he said. “You almost have to get the training wheels back on in the individual’s life but, at the same time, make sure that they have confidence and belief in their own abilities to not demoralize the individual during this rough transition.”
Above all, Kononov preaches patience—and self-care. Though a patient’s actions might be inappropriate or appear bothersome to an outside person, it’s important to remember that it’s not being done with malice.
For caregivers themselves, Kononov said it is important to understand when they are at the point of burnout and need a break. “You are doing everything you can for your parent, for your loved one. What about yourself? Many times, those of us in a caregiving role tend to divert all of the mental and physical resources towards the individual that we’re caring for—be it our child, be it our parent—and neglect or don’t acknowledge our own needs,” he said. “Knowing when to pause and step away from the situation or knowing when to recruit additional help, be it from other family members or social services, is important.”
To schedule an appointment with senior behavioral health, call 419383-5695.
Tyrel Linkhorn is a communications specialist at The University of Toledo.
✲
