Caregiving in the Early Stages of Alzheimer's: Aim for Less Stress

Post #16

We’ve all been told that too much stress is not good for us, and I can testify to this personally as I’m especially vulnerable, even to every day stress. Throughout the day I can feel minor conflicts or worries work havoc on my body—I usually begin with a feeling of nausea or digestive upset; before I know it I have aches in my shoulders, as well as my back, and eventually a migraine that pushes me to grab a pair of sunglasses and shut the blinds while I try to block out external noise with with some type of white noise next to my head.

Thankfully, not everyone reacts as I do to consistent, every day stress, but we are all vulnerable to extreme stress, such as the death of a loved one, the loss of a job . . .Keeping life as stress free as possible is important for those with health conditions, especially Alzheimer’s. According to experts “added stress drives progression of the disease and can exacerbate symptoms” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991350/. (An article by Nicholas J. Justice, The Relationship Between Stress and Alzheimer’s Disease)

After attending workshops and support groups and devouring books and articles, I’ve discovered that there are at least two over-reactions that family caregivers often engage in that can create stress in our loved one, especially in the earlier stages of Alzheimer’s. Before we realize there is a real problem with our loved one, we often become too critical. After we understand that a real problem exists (even though we might not be able to name it), it is common to become over protective. Of course, some of us react one of those ways consistently and other caregivers may be overprotective in some situations, and criticize the one they are caring for at other times.

When we criticize the person(s) we are caring for, we are probably causing them a great deal of stress. After all, they are trying to cope with why they can’t remember things or why the wrong word comes out when they are trying to communicate. We may not mean to sound critical when we make statements such as “Mom, you aren’t acting like yourself. You always used to wash your hair three times a week.” Or “Dad, you really need to wear two shoes of the same color. You look like a little kid.” Sometimes it’s merely the tone of voice that can create stress—people with Alzheimer's sense emotional overtones, even if their brain can't explain what they are sensing. Your loved one will feel stress from being treated differently--whether it’s suddenly being spoken to like a child, or actually being yelled at because the caregiver is stressed over the whole situation (as well as life’s other problems).

I think it is helpful to take a moment before reacting to the unusual behavior of someone with Alzheimer’s. Deep breaths help us to slow down and find compassion within before saying something that will increase the care receiver’s stress, causing them to react, which will probably increase our stress . . . and the chain reaction can continue to escalate. Of course, we all make mistakes and find ourselves reacting emotionally, then later regretting it. I’ve found it helpful to rethink the situation when I’m alone and calm. How should I respond if this happens again? When trying to talk my mom into taking a shower, how could I have ended the conversation rather than telling her that she stank?

Staying calm gets harder as a person progresses in Alzheimer’s because they have lost the ability to reason. In order to keep the situation stress free, I’ve learned to address the emotions—keep things calm and loving—even when the loved one refuses everything I suggest. I think it helps, if we establish a kind atmosphere and calm practices that reduce stress early in our caregiving experience.

Being overly protective may also create stress for the person who is in the early stages of Alzheimer’s disease. “What do you mean I can’t go on my daily walk?” “I really want to take care of the grandkids, why won’t you let me?” Not being allowed to continue one’s favorite activities can be overwhelming. I remember that when my mom got rid of all my dad’s guns, he had a total meltdown. He had owned a rifle for hunting since he was a little boy on the farm—and collecting guns had been a big part of his life even though he hadn’t really hunted in several years.

For safety reasons, there didn’t seem to be a way to avoid the stress my dad experienced in this situation. However, in many instances a slow adaptation will lessen the stress experienced. For example, you might find someone to walk daily with your loved one or bring the grandkids over and let grandma/pa enjoy them while you stay in another room within hearing distance. Both walking and caring for grandkids are stress relievers and should not be neglected. Studies have shown that consistent exercise and strong social connections, especially with family, will keep your brain healthier.

There are many other activities that keep the brain active and healthy. Logically, a healthy brain is more able to handle stress. One of my favorite Ted Talks on taking care of your brain is given by Elizabeth Amini whose educational background is science but her passion is “played out” in her business, Anti-AgingGames.com. I haven’t looked at her website, but I frequently look back at the notes I took during her talk. I recommend watching it, so that you can help your loved one in the early stages of Alzheimers or other dementia to involve their brain in these activities. Of course, her advice is also great for self care. https://youtu.be/2tcEgqTWbxQ When the caregiver and care receiver’s brains are both engaged in these activities, it seems to me that the relationship will be a healthier one.

I’ve found it takes an attentive, creative, and adaptive caregiver to help someone in the earlier stages of Alzheimer’s get the most out of life by lessening the stress they experience. Being attentive requires watching their responses and listening to their complaints and affirmations to find out what will give them more happiness and less stress. Being creative and adaptive requires borrowing from the ideas and experiences of others and adjusting them to fit your loved one’s needs and desires. With some effort on your part, your loved one will continue to adjust to each “new normal”* with a lesser degree of stress.

*The “new normal” is a term used to indicate an acceptance of a life change. In Alzheimer’s the “new normal” is usually a constant adjustment to diminishing abilities. However, there are new studies that hold out hope for halting or even reversing the decline of abilities due to Alzheimer’s. (One example is Dr. Bredesen’s protocol as explained in his book, The End of Alzheimer’s. https://www.endcognitivedecline.com/about/)