Looking after patients who can no longer recognise family members or remember life’s daily activities can take a heavy toll on caregivers
He wakes up at 2am every night and demands breakfast. After eating, he asks for food again, shouting at his maid and accusing her of trying to starve him. He also showers several times a day because he forgets that he has already done so.
The man is in his 90s and has dementia – a debilitating illness that is marked by progressive memory loss, particularly in recalling more recent events. Because of the personality and behavioural changes that accompany the disease, caring for a person with dementia can physically and mentally drain the caregiver, who is often the spouse or the maid.
“Dementia is devastating because it robs the family of a family member. He may not be able to recognise his family members, which adds to their pain and burden. He may get delusions, or make repetitive motor actions that lead to increased friction between him and his caregiver,” said Dr Dennis Seow, Consultant, Department of Geriatric Medicine (Memory Clinic), Singapore General Hospital (SGH).
“In illnesses like hypertension, the caregiver can just give the patient his medication and wait for it to take effect. But in dementia, the disease affects so many areas of the patient’s life, and good care has shown to have as great or greater impact as medication.”
Course for caregivers
Many people don’t realise how difficult it is caring for a dementia patient and dealing with behavioural problems. To help carers look after dementia patients, the Department of Geriatric Medicine (Memory Clinic) started a course for caregivers in July last year. Running over six weeks, the course helps caregivers understand the disease, how it changes over time, how the changes affect the patients, and how to handle difficult behaviour such as not wanting to bathe or eat, or when the patient becomes delusional.
The course also looked at the legal and social aspects associated with the illness, including wills and community resources that are available to the families of dementia patients. “When someone is diagnosed as demented, there are lots of personal, ethical, social, occupational and legal implications,” said Dr Seow.
Caregivers are given practical tips on looking after dementia patients, such as fall prevention. During the course, they can also air their views and share information and their experiences with other caregivers, said Dr Seow.
Ms Julian Lee, a Nurse Clinician specialising in dementia care at SGH, said caregivers she sees at the hospital’s geriatric clinic sessions are stressed to the point where they can no longer cope with the 24/7 pace of caring for the patient. They may also be clueless about how to deal with the patient’s aggressive or unreasonable behaviour.
Giving them pamphlets and brochures can provide them with a basic understanding of the patient’s condition but, often, they aren’t enough to help a full-time carer deal with the various issues that can emerge, she added.
Feedback from people who attended the course has been largely positive, with many finding the sessions useful in helping them gain a deeper understanding of the disease and the behaviour of the patients. “This helped them care for their loved ones better,” said Ms Lee.