Caring for Elderly with Dementia: Challenges and Stories from Caregivers

2023-08-08 02:10:48

Taking care of the elderly with dementia is not easy, the Facebook page “Lao Zhi Hao – Hong Kong Geriatric Society HKGSStarting from patient education, I shared a caregiver’s story recently. A son took his mother with dementia to follow-up visits. He has been trying his best to take care of his mother who lacks self-care ability. Kicked out of the house, he exhausted himself and cried, “I wish she could get hit by a car…”

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【When dementia caregivers need follow-up visits more than patients】

The youngest son said, “I really wish she could get hit by a car when she goes out on the street…”

This is a true dialogue of a patient’s son.

Memory Clinic, a clinic for patients with complex dementias. Generally, a half-day outpatient clinic can only see 4 to 5 patients at most, and each patient takes up to half an hour. This is a very luxurious service for public hospitals, but it often takes time not because it is difficult to diagnose the disease, but because You have to deal with the various care issues that accompany the illness and the stress of the caregivers, just like the mother and son who encountered this day.

A strong son walked into the room with a brisk middle-aged mother. If it wasn’t for a follow-up visit, she would never be noticed as a patient on the street.

As soon as I sat down, I asked habitually, “Ms. Wang, who are you going to follow up with today?” In addition to clarifying the relationship, I also wanted to test whether the patient could still recognize his family.

She replied without hesitation, “He is my eldest son.” However, the son sitting behind her immediately looked at me, shook his head, and indicated that he was not the eldest son.

This is a signal that her answers below may not be accurate. She quickly answered the next few questions.

“Has your memory deteriorated recently?” “It’s a little bit amnesia, but it’s about the same as before.”
“Is it difficult to go to the toilet or take a shower by yourself?” “No! It’s just that sometimes I can’t go to the bathroom in time and I have to solve it in the trash can.”
“Did you take your medicine on time?” “Of course! Take it as soon as you remember!”

As she answered, the youngest son kept shaking his head. Every answer the mother gave did not reflect the facts. Upon seeing this, I invited Ms. Wang to wait outside first. I wanted to have a private talk with my youngest son.

As soon as the mother left, the son said, “Doctor, I’m really raising the white flag! I’m really messing with you…”

It turned out that the youngest son had been living with his mother until the onset of her cognitive impairment. He witnessed the decline of his mother’s memory, and her stubborn and stubborn personality became more and more serious. The ensuing friction in life continued to increase, and she even blamed her son for stealing what she had lost. No matter what difficulties she encountered in life, she habitually denied and refused her son’s help. As her ability to take care of herself gradually declined, she began to urinate and urinate in the trash can again. This was actually because she had forgotten where the bathroom was, not because she couldn’t help it as she said.

Later, she even mistook the younger son as the eldest son, kept counting the faults of the younger son (himself) in front of him, and finally even kicked him out of the house with her own hands, saying “When I never gave birth to you”, “I never gave birth to you.” You don’t even have to come to worship the mountain even if I’m dead” and other heartbreaking words. Even though he knew that his mother could not take care of himself, the youngest son had no choice but to move away. He knew rationally that his mother had all kinds of behavioral problems due to illness, but he was constantly hit emotionally.

“She didn’t know that the son she talked about the most was actually the one who accompanied her every time for follow-up visits.” The eldest son, whom the mother mistook, actually suffered from emotional illness due to taking care of his mother. As a result, the youngest son became the mother’s only caregiver, and also became the person the mother hated the most.

As he spoke, the youngest son also shed tears.

“I have tried different ways to take care of her remotely, such as installing a camera at home to remind my mother to take medicine, but every time I checked, I found that a lot of medicine was left; I also arranged for a food delivery service, but she even forgot to have someone to deliver the food. The food delivery staff touched the doornails; I also installed the “safety bell”, but my mother thought she didn’t need it, so she terminated the service.”

The youngest son has also tried many care techniques and methods suggested by doctors, but for these patients who are in normal health and don’t know that they are sick, they don’t need it at all, let alone send her to a nursing home, which she refused early in the morning . How can anyone send her to a nursing home if she is “able to walk”? This just raises more questions.

To be honest, this type of patient is one of the most difficult and dangerous to deal with. They have poor memory but no insight. Sometimes doctors and social workers are helpless.

“I understand that you are working hard, it must be difficult for you.” Faced with this situation, doctors can only listen as much as possible. In addition, I also introduce some services specially designed for caregivers of dementia, such as “Wisdom Friends Medical Institution Fellowship Program“(Dementia Community Support Scheme), hoping to relieve his stress.

As for his mother, this situation may last for a while, until something makes her realize that she can no longer take care of herself, and it will be easier to persuade her to enter the residential care home. As for what? We don’t know either.

“Oh, I really wish she was hit by a car when she went out on the street…” This sentence sounds vicious and inhuman at first, but every word is actually heartbreaking.

Sometimes, caregivers may need follow-up visits and support more than patients. It’s really hard work!

8 Symptoms of Dementia

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12 tips for dealing with stress in caring for the chronically ill

According to the information from the Center for Health Protection of the Hong Kong Department of Health, some patients with chronic diseases need long-term care from their family members. If the carers in the family are overly involved in the role of carers and neglect their own needs, it can lead to great mental and physical stress. If the caregiver fails to properly deal with these pressures, it may lead to a mental state of “burnout”, such as physical fatigue, easy illness, negative thoughts, negative attitudes, depression and easy temper tantrums.

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The content is “Lao Zhi Hao – Hong Kong Geriatric Society HKGSReprinted with permission. The story is a real case, and the names, identities, and some medical conditions and scenes of the characters are fictitious to protect the privacy of the parties involved.

Dementia｜A 90-year-old mother-in-law suffers from lung cancer. It is difficult to take care of her wheelchair-bound demented wife. She feels guilty about sending her to a nursing home. See details:【Next page】

Family Tragedy｜Mother-in-law with Cognitive Impairment and Stroke in her 90s, She Was Suspected of Being Abuse by Her Son in Hospital

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