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When
Caring for Aging Relatives Stirs Up Unwelcome Emotions
By
Sue Shellenbarger Wall
Street Journal, July 17, 2003 It was a moment Vanessa Morgan would like to forget. Her 74-year-old mother, who has Alzheimer's disease and lives with Ms. Morgan, was arguing with her as she tried to talk on the phone. The topic was an old annoyance -- a bulging stash of old plastic wrappings her mother was hoarding, cluttering the kitchen. Finally, Ms. Morgan -- normally a conscientious caregiver -- lost it. Stressed by her night-shift job, tired, and depressed by her mother's condition, "I grabbed her on the arm and shoved her," she says. Seeing fear on her mother's face, Ms. Morgan pulled back and vowed never to lose her temper again. It's not nice when you feel like slugging Grandma. But a growing number of caregivers to the elderly find themselves struggling to manage emotions they wish they didn't have. As old people live longer, more are beset by dementia and other cognitive ailments that can make them irritable, unreasonable and hard to care for. The stresses can be numbing. Some turn their anger inward: About 25% of caregivers to the elderly are depressed, studies show, more than twice the rate in the population as a whole. Old people stressed by caring for disabled spouses run a 63% higher chance of dying of various causes than other people their age, says a 1999 study in the Journal of the American Medical Association. Other caregivers -- a small number, say experts -- turn their anger on their relative. An estimated two million old and disabled adults are abused or neglected each year, and the numbers are rising, says William Benson, a Silver Springs, Md., consultant. The mistreatment ranges from denying needed medical care to verbal abuse, physical assault or stealing assets. Far more often, conscientious caregivers restrain themselves, even when pushed to their limits. Ms. Morgan, 45, of Ypsilanti, Mich., tends lovingly to her mother every day, cooking meals to reverse her weight loss, arranging day care and exercise classes and overseeing her medications. She tells her story of losing control, she says, only because she wants to help other caregivers and raise awareness. Now, there's good news for family caregivers: Growth in programs and educational techniques to ease strain. The federal Administration on Aging is handing out $140 million in grants to states for caregiver training and respite care, among other supports. Innovative nonprofits such as the Family Caregiver Alliance, San Francisco, are driving growth in online help and classes. And at several universities, researchers are applying stress- and behavior-management techniques to the needs of elder caregivers. Some are training caregivers how to relax on the spot. Dolores Gallagher-Thompson, a researcher at Stanford University and the Veterans' Administration Medical Center, Menlo Park, Calif., teaches them to stop before reacting in anger to a frustrating situation. She shows caregivers breathing exercises instead: Turn your attention on your breathing; count to four while inhaling and again while exhaling. Focus on how your lungs feel when they're full, and empty. Relax all your muscles; continue for several minutes.
Behavior-management techniques -- similar to those we use with children -- can help check an uncooperative elder. If you feel like yelling at your aged mother for, say, asking four times for lunch right after she's just eaten, distract her instead with another activity. If problem behaviors persist, step back and figure out what triggers them -- then change the trigger, Dr. Steffen says. If a task is too complex, simplify it. And make a point of reinforcing positive behavior in your relative. Another principle: Remove yourself from conflicts. In 18 years of caring for his wife, who has Alzheimer's, David Smith, 72, a Carlisle, Mass., art-gallery owner, struggled with her refusals to cooperate. Sometimes she wouldn't bathe. Her nightly wanderings kept him awake. Once, she pulled a butcher knife on him. "You want to scream, or lash out. You get so frustrated," he says. Often, he found removing himself from conflicts worked best. "I'd go into the bathroom and lock the door and bang my head against the wall a couple or three times -- anything to interrupt the flow." Joining a caregivers' support group helped; now, he occasionally leads the group. Learn to communicate better with your doctor, too. Too often, physicians see demented elders only at their best, and fail to prescribe needed medications or resources. Next week, the Alzheimer's Association will start setting up classes in 36 states to train caregivers how to talk to doctors about specific behavioral and health problems. Finally, researchers tell caregivers to enrich their lives. In a simple truth that evades many of us, Dr. Steffen teaches that daily events affect our moods, and adding pleasant activities will help improve our outlook. Ms. Morgan, a caregiver in Dr. Steffen's program, has learned to plan diversions; she is collecting videotapes of movies. She attends caregiving conferences and speaks on panels. Among her messages: Caregivers should give themselves more credit for the good that they do. Copyright
© 2002 Global Action on Aging
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![[chart]](stir1.gif)
Such
exercises can be used in the midst of whatever you're doing, even if it's
helping a frightened elder out of the bathtub, says Ann Steffen, director
of gerontology at the University of Missouri, St. Louis, who is running a
research project teaching stress-reduction skills to 80 caregivers.