How Alzheimer's illness has implications for caretakers

Alzheimer's disease has an impact on the person who suffers from it and also on his or her family. The caregiver may have physiological, cognitive, affective, social, or work-related problems, so it is essential to develop life skills, i.e., the necessary aptitudes to behave appropriately and positively to effectively face daily demands.

María Eugenia Gutiérrez Ordóñez, professor at the Faculty of Psychology (FP) of the UNAM, said that it is a neurocognitive disorder that implies a deterioration in the higher functions of the brain due to neuronal death. It appears after the age of 65, and the probability of its occurrence increases with age; at 87, it is 47 percent.

There are no strategies to prevent it. In most cases, it appears due to genetic issues in up to five generations of predecessors. But it has been found that keeping the brain active with things like reading or crossword puzzles, for example, keeps cognitive activity up and helps keep this organ from getting worse.

It evolves and consists of three stages: mild, moderate, and severe. Some authors propose more, which range from the patient showing no changes in mood or intellectual problems, to loss of language, walking difficulties, and rigid body, when Alzheimer's disease is severe and is the most difficult for the family.

When the diagnosis is given, the relatives do not believe it and begin to seek other medical opinions; they present anguish and anxiety that derive from strong fears for the future that awaits them. Family dynamics are transformed when the patient moves with a child to be treated.

Sometimes it is considered an inopportune moment, because the family members study or work, and no one stays at home. Feelings of ambivalence begin to arise because people think: "he is my father and I have to take care of him," but they weigh the activities that they will no longer be able to perform.

Alzheimer's Disease and the Caregivers

With the next stage, moderate Alzheimer's comes feelings of helplessness because the family cannot do much about the progression of the disease. Sadness and affective lability arise; one may feel that one loves or hates the patient, or suffer depression or frustration. In the severe form, there is strong fatigue because the patient loses functions and requires help to bathe, walk, eat, etcetera. There is also a feeling of loneliness in the caregiver because he/she has been socially isolated.

Added to this is the economic impact since this is an expensive disorder and the medications needed to halt the deterioration process, i.e., neurological drugs, are costly. In addition, it is complicated because it can vary from one moment to another and reach a severe episode quickly; this depends on each person.

When the disease begins, family members divide the care. However, as it progresses, it is usually only one person who is in charge. In this primary caregiver, physiological problems such as tachycardia and muscle tension are recorded; blood pressure and cardiac and respiratory rhythms may increase, as well as depression of the immune system. Also, hernias and lumbago are due to the effort of carrying or moving the patient.

Similarly, cognitive problems such as lack of attention and concentration, worries, the appearance of repetitive thoughts, and memory impairment, which is delicate because the patient's medication may be taken again and again, and there are even cases of intoxication in the patient.

Life Skills in the Primary Care

The primary caregiver may also show emotional or affective difficulties such as fear, anxiety, anguish, excitement, and anger, which are not favorable and may even lead to mistreatment of the patient; in addition, social problems, including limited free time and an overload of domestic activities; and work problems, such as loss of employment due to absenteeism, among other factors.

They frequently cannot tolerate lengthy therapy or intervention. Therefore, psychologists must provide strategies called "life skills," said the expert at the conference organized by the Unit for the Development of Teaching Materials and Technological Appropriation of the Faculty of Psychology.

Among them, self-knowledge, or recognizing our being, our character, strengths, values, likes and dislikes; empathy, or the ability to recognize and understand the emotions of others; the motivations and reasons that explain their behavior; as well as assertive communication, or the ability to express oneself clearly in a given situation, in this case, asking for help from other members of the family.

In conclusion, María Eugenia Gutiérrez advised seeking serious information, guidance, and care; in some cases, it is also necessary to take charge of the patient's financial affairs, share feelings and problems, as well as to organize oneself. Meanwhile, the patient must accept his or her limitations, i.e., live with the disease.