Adult children often report one of the most uncomfortable parts of this role reversal is discussing tough topics with their parents. Some of these loaded topics include finances, memory and mental health, driving, moving, and bringing help into the home and end of life. Here are 7 tips to improve communication with your older loved one:

1. Create an agenda. When you decide that it’s time to discuss some tough topics with your older parent, set an agenda for yourself. Think about what your goals are for the conversation. Consider whether a public setting, such as a restaurant, would be a better location for the conversation rather than at home. Changing the venue to Mom’s favorite cafe rather than the kitchen in which you spent your childhood can make the discussion less intimidating.

In planning an agenda, it is important to contemplate the desired outcome of this particular conversation. Are you hoping Mom will agree by the end of the conversation to make a change or is this conversation going to be the first gentle introduction of a tough topic?

2. Educate yourself. Learn about the aging process as much as you can. When you understand what normal aging truly looks like, it will help you to determine what is going on with your older loved ones. Dementia, depression and anxiety disorders are not part of the normal aging process. On the other hand, some functions like reflexes and metabolism are less efficient for everyone as we get older. When you understand more about what’s to be expected at your parents’ age, you will have an easier time helping them to understand. When you are researching aging online, be sure to visit websites established by credible organizations such as National Institute on Aging (www.nia.nih.gov) and Alliance for Aging Research (www.agingresearch.org).

3. Set a good example. If you want to discuss your parents’ finances or end of life plans, show them a copy of your will and advance directives. Everyone over eighteen years old should have these documents. When your older loved one sees that you have your finances and healthcare decisions in order, particularly when you are several decades younger, it may motivate them to do the same. This can segue into a conversation about money and wishes about end of life care.

4. Be persistent. Understand that most of the time these tough conversations will require several attempts before you get results. Be on the lookout for changes that are natural openings for revisiting a conversation. A frequent catalyst for a productive change discussion is when a peer of the older parent is hospitalized, becomes ill or moves.

5. Empathize. While persistence is necessary with these tough conversations, empathy and patience are important too. Through your body language, tone of voice and word choices, show that you understand your parent may feel uncomfortable discussing some of these subjects. For example, maybe your mother is ashamed of her recent car accident and is terrified of losing the independence driving represents. It is important to acknowledge her feelings while discussing the reality of her diminishing abilities behind the wheel.

6. Explain how it’s affecting you. If you are asking your mother to see a doctor because she seems to lack energy, explain why it’s important to you and others she cares about. Have her granddaughters noticed that she hasn’t been coming to their softball games anymore? Have you been late to work four times in the past month because Mom calls you each morning to discuss worries about her health? Consider keeping a written log of how the issue is affecting you and other loved ones and refer to it before the conversation. Often specific examples of how a parents’ behavior is impacting others can prompt change better than conversations on why taking action would be best for the parent.

7. Involve others who care about your parent. Sometimes the person closest to the older loved one is not always the most effective communicator for these conversations. Often persons less involved with the senior’s daily life can be invaluable in emphasizing the need to discuss these tough topics. Perhaps a trusted minister or rabbi can help a senior understand the benefits of addressing end of life decisions ahead of time, while acknowledging fears around death. A respected friend of the family who works in healthcare may be able to better explain the age-related changes that make driving more difficult without making the senior feel guilty. Perhaps you have a brother that lives across the country and Mom tends to listen more closely to what he says because she sees him less frequently.

Some adult children are reluctant to involve others in these important conversations because they don’t want to violate the parents’ privacy or because there is some embarrassment that they can’t get through to them. Ultimately, the results of the conversations are what matters.

Most of us have heard the quote “it takes a village to raise a child.” With tough and sensitive topics such as driving, memory, finances and end of life, adult children need to apply this concept when attempting to help their older parents. Seeking help from trusted friends, family and professionals can help you prepare for the tough conversations facing anyone dealing with an aging parent.

The website www.lotsahelpinghands.org is a wonderful, free resource that makes the process of asking others for help easier. The caregiver can set up a web page that explains the older adult’s circumstances (e.g. Alzheimer’s disease or cancer diagnosis). Then the caregiver will list what types of help are needed. This can include all types of activities, such as something that is needed regularly or even one-time favors. The following are examples of possible postings that caregivers can make:

• Grocery shopping for us once a week
• Taking Dad to a medical appointment next Tuesday at 10 a.m.
• Bringing dinner for Mom once per month when my teens have baseball practice
• Contributing money toward Dad’s prescription co-pays
• Spending an hour with Mom once per month so I can exercise
• Research potential side effects of Dad’s new medication

This system allows the caregiver to invite family, friends and neighbors via e-mail to participate. The beauty of this program is that messages about what is going on with the older loved one are disseminated to everyone at once so the caregiver’s needs are immediately known to the entire network of loved ones. Family and friends can choose to sign up for items that fit their schedule, budget or comfort level. Depending on the type of tasks the caregiver posts, even children and family at a distance can participate.

Though some friends and family might not be comfortable driving Dad to the doctor’s office, they might be very happy to cook an extra meal once each week to bring over. While some needs the caregiver lists may go unassigned, stressed caregivers are significantly likely to reduce their load by using this website.

What Is Sexuality?

Sexuality is not simply about sexual behavior or intercourse.  Sexuality has to do with one’s identity as a man or woman, a straight or gay person.  It can be about the enjoyment of putting on lipstick, cologne or an attractive outfit.  Sexuality can be about romance and companionship.  Sexuality for some older adults can mean connecting with someone physically through a variety of sexual behaviors.  For single, divorced or widowed older adults, sexuality can be about the hope and possibility of meeting someone with whom they can connect.  Sexuality can simply be about enjoying the sensuality of one’s own body through a foot massage or even masturbation.

Sexual activity can also be very good for our overall health.  Many studies suggest that sex bolsters the immune system, reduces stress and improves cardiovascular health. 

Sexuality As We Age

Most older adults can perform sexually if they would like to, but there are some barriers.  Since women tend to live longer than men, older heterosexual women who may desire a sexual or romantic relationship frequently encounter a lack of available partners.  Older females are also more frequently caregiving so this may leave them with less energy to pursue or maintain a sexual relationship. The current cohort of older adults tends to be conservatively religious and those beliefs may inhibit initiating a sexual relationship when single, divorced or widowed. 

Hormonal changes take place for both men and women.  Nearly everyone has heard the jokes about the stereotypical menopausal moodiness.   But these jokes can downplay how truly life-altering menopause can be. Menopause occurs when a woman has gone twelve consecutive months without a menstrual period.  While the news is filled with reports about how much fertility drops in the thirties and forties, there is still a chance, albeit very slight, for women to become pregnant until menopause is completed.  Along with the loss of ability to become pregnant, there is a significant drop in estrogen which typically occurs in the early fifties.

Older women frequently experience some discomfort with intercourse after menopause due to a condition known as urogenital atrophy.  Urogenital atrophy is the lessening of lubrication and thinning of skin in the vaginal area.  Urogenital atrophy can even cause some light bleeding for sexually active older women. Minimizing symptoms of urogenital atrophy can be accomplished by having regular sex, masturbating and using lubricants when sexually active.  Comfortability for older women having sex is truly a “use it or lose it” scenario.  If a woman has not been sexually active in a while, it is important for her to use lubricants and discuss with her doctor if she continues to be uncomfortable as there are some other treatments that may be able to help.

 Viropause or andropause is sometimes referred to as the male version of menopause. It involves a very gradual decrease in testosterone, beginning usually in the early fifties.  Sexual response for older men also changes.  Orgasms tend to be less intense, erections are a bit less firm, and refractory periods are longer. Occasional impotence does happen to older men and some may be quick to ask the doctor for performance-enhancing drugs.  Older men may want to try being a bit more patient by enjoying additional minutes of foreplay, instead of immediately assuming they require medication for erectile dysfunction.  It is going to take more time for an older man to achieve an erection than a younger man but this does not mean that drugs are necessarily required. 

Safer Sex Tips For Seniors

Practicing safe sex has many meanings, especially for older adults.  Here are some tips to help seniors navigate their sexuality as safely as possible:

1.  Prevent pregnancy.  Sometimes it is forgotten that men of any age can impregnate a woman.  It is important for older men dating or married to women who have not completed menopause to remember that birth control is still crucial if an unplanned pregnancy would be a major disruption to their lives. 
2. Use condoms.  The use of latex condoms, by far, is the best way to prevent HIV and sexually transmitted infections (STIs), outside of abstinence.  Older adults, just like sexually active persons of any age, need to take precautions against HIV, herpes and other STIs.  Unfortunately, the Kinsey Institute reports that condom use is low in the over 50 population (only about 1/3 of those older than 50 interviewed for a recent study indicated they used condoms during their last sexual encounter). While much public health education about STIs tends to focus on teens and young adults, the most recent statistics available from Centers for Disease Control and Prevention (CDC) indicate that 15% of all new HIV cases are persons age 50 or older.
3. Consider the impact on acute and chronic conditions. Further, seniors with other health conditions need to consider them in order to have the safest sex possible.  If a senior has arthritis or paralysis due to a stroke, it is important to seek positions that will make sex as comfortable as possible.  If an older adult has a history of heart attack, discussing any concerns or anxiety with a doctor is important.  If a man is experiencing regular impotence even when engaging in lengthy foreplay sessions, it is important to consider if there is a medication side effect or an undiagnosed condition.  Sometimes healthcare providers don’t initiate such discussions, especially when the senior is single, because they wrongly assume they are not needed.  It is important for an older adult to take initiative with doctors in these discussions when there are concerns.
4. Don’t worry about what everybody else says.  Some seniors can be reluctant to date or get involved in new romantic relationships because they worry about what their adult children, grandchildren, friends or even the neighbors might say.  Seniors have already lived full lives, raising families and making contributions to the workplace and community.  They are adults entitled to make their own decisions about dating and sex. If a single senior has connected with someone, she has every right to reap the health and psychological benefits of sex, romance and companionship. As more seniors date, remain vital, and push against the stereotype, we will see younger generations accepting and looking forward to their own sexually fulfilling golden years.

In conclusion, most older adults can enjoy an active healthy sex life if they want one.  While sexual response may change a bit with age, the fun of romance and the comfort of companionship can help seniors feeling youthful.

Gerontology–the study of aging—is becoming an increasingly popular college major due to the aging population explosion. On the first day of the semester, a gerontology professor recently asked the class, “what age do you consider ‘old?’” The most common response, 30, came from the 18-21 year old students. 30! After some good-natured groans by the non-traditional age “returning” students, the professor discussed that around 30 is when some aging processes in our bodies start, but by no means does 30 count as ‘old’. Unfortunately their answer is not surprising: American society idealizes youth and dreads aging.

 Instead of dreading aging, it is important to understand it so people can best prepare themselves for the journey. While most stereotypes about older adults are greatly exaggerated, many biological changes do take place both physically and cognitively. Nearly every organ and system in the body is a bit less efficient than it once was but this does not mean inevitable disease or disability. People have much more power over how they age than most realize. This control extends not only to the physical body but also impacts other major areas of life: socialization, finances, romantic relationships, work and hobbies, and mental health.

 Physical Aging

 Many people tend to think of older adults living in nursing homes and needing help getting around. It is true that older adults are more susceptible to a number of chronic and acute conditions. But getting sick is not the norm; in fact most older adults are healthy and live in their own homes. While aging organs and systems are less efficient and everyone has to contend with any genetic baggage handed down to them, individuals maintain significant control over how they experience much of the physical aging experience.

 Most human bodies are quite resilient during early adulthood. For example, smoking usually does not have an immediate impact on a younger person. But an older person’s ability to take in oxygen diminishes slightly so not only does smoking contribute to diseases like emphysema but it also decreases already reduced oxygen capacity. While a younger person may be able to get away with eating a high fat diet and skimping on exercise, older adults will see more negative consequences. During aging, everyone’s blood pressure rises a bit and metabolic rates slow down. These naturally occurring processes make those negative habits riskier. On the other hand, when a senior takes good care of himself, he is much less likely to see problems such as heart attack, weight gain or respiratory conditions.

 Finances

 There’s no question about it: aging is a whole lot easier when we have financially prepared for retirement. This is one of the most important things a person can do to positively impact her aging experience. More money always translates to better options for both needs and wants. Retirement is obviously going to be more fun if you can take a spontaneous trip to the beach when your friends call. When a senior has access to sufficient funds, there is much more control about if, and when, he wants to remain at home if his health declines. Too many seniors are living below their pre-retirement standard because they believed the myth that Social Security and Medicare benefits will cover all necessities.

 If a middle-aged or elderly person has not planned well for retirement, it may not be too late to improve the situation. Deferring Social Security payments, remaining employed longer, and seeking estate planning advice from an elder law attorney or trusted financial advisor are some possible strategies for improving financial status.

 Work/Hobby

 The one part of aging that Americans actually seem to look forward to is retirement. Particularly when the senior is financially comfortable, the idea of endless free time may be appealing. In reality, plans to golf, volunteer at church, babysit the grandchildren, travel or redecorate the house is essential to a happy retirement. Projects and plans that stimulate the mind, encourage socialization, and promote feelings of productivity can keep seniors healthier both mentally and physically.

 Romantic Relationships

 A common myth is that most seniors are asexual and older men are impotent. The reality is that most seniors can enjoy sexual relationships if they want. There are medications and health conditions that can inhibit sexual feelings and performance, but these situations can be addressed if the senior communicates openly with his physician. It is normal to be sexually active during the later years of life.

 A healthy sex life is associated with positive mental and physical health. Seniors with spouses or partners should prioritize sexual and romantic satisfaction. Single or widowed seniors may consider dating. In fact, the over 50 population is one of the fastest growing segments of online dating.

 Mental Health & Cognition

 Clinical depression is not a natural part of the aging process, despite the stereotype of the lonely, sad older woman living by herself. We are more likely to suffer losses during the aging process and those losses can certainly trigger someone who has struggled with depression previously or even initiate a first-time diagnosis. For example, a recently widowed senior who is no longer able to drive and is moving into an assisted living community may have a very positive outlook despite typical feelings of grief and loss. Another person experiencing similar circumstances may need medication and counseling to combat the depression diagnosis that occurs. Seniors need to realize that changes in mental health status are not to be accepted as part of getting older; they need to be discussed and treated by the doctor just like any other illness.

 Memory and aging is another area that is typically misunderstood. While Alzheimer’s disease and permanent dementia are not part of the normal aging process, tip of the tongue moments and slower reflex, reaction and recall times are. Any challenges with short-term memory and confusion should immediately be addressed with a doctor. There are many reasons besides Alzheimer’s disease that these issues can occur. Many of them, including urinary tract infections, dehydration, and medication side effects can be reversed with proper treatment. Seniors should never tolerate being told that forgetting their grandchild’s name is a normal part of getting older.

 Exercise, eating healthfully, socializing with friends and family and reducing stress are associated with positive mental and cognitive health. Since heart disease, diabetes and head injuries are linked with permanent dementia, it is important to prevent these or manage them responsibly if they occur.

 Americans have every reason to look forward to getting older, especially when they take control of the aging process through healthy habits. Dispelling myths and stereotypes about getting older is an important step to creating a society that embraces aging instead of fearing it.

How do you ensure your organization is remembered when a healthcare provider has an appropriate patient or client who would be a great fit for what you offer? Hosting a professional event can be a fantastic way for your community to showcase its services and offerings so nurses, social workers, and other professionals can understand how you can help those they serve.

Consider the following success strategies when hosting such an event in order to get the best results possible:

Two To Four Months Before The Event

• Decide who your targeted event guests should be. Frequently, senior living community events are focused on case managers, nurses and social workers. But have you determined if there are other types of professionals who are in a position to make referrals? Consider targeting additional professionals such as:
-Physical, occupational & speech therapists
-Psychotherapists, including psychologists and licensed counselors
-Elder law & estate planning attorneys
-Nursing home, assisted living and adult day administrators
-Area Agency on Aging staff
-Home care and hospice managers
-Nurse practitioners and physician’s assistants
-Activity professionals
-Pharmacists
-Dieticians
-Morticians
-Physicians, including neurologists, psychiatrists and geriatricians
-A blended audience of numerous different disciplines

• Consult your existing referral sources for input on what type of event to host. Speak with some of your key referral sources and ask what type of events they prefer. For example, if you want elder law attorneys to attend your event, ask some elder law attorneys for their opinions. Would they appreciate a networking breakfast? A continuing education program over lunch? A happy hour after work? A weekend open house? The most convenient time of day and day of the week may vary based on the groups you are inviting.

• Choose partners for your event. Good speakers, refreshments, entertainment and other event expenses can be costly. If your budget is limited for the type of event you’d like to host, seek a partner to share costs. Obviously two assisted living communities competing for the same referrals may not want to collaborate. But an assisted living may choose to partner with a hospice, home care, medical equipment or pharmaceutical company. This also can increase publicity for the event since all partners can promote to their databases.

• Publicize your event well in advance. If your community has a reputation for providing regular professional events, 6-8 weeks may be enough time. If this is the first time your community is doing one, 2-4 months may be needed. Often people need to hear about your event several times before they commit to attending. Invite your targeted guests several times and in several ways. Mail invitations, deliver them in person during sales calls, send e-blasts, fax blitzes and make announcements during other community events when the opportunity arises.

Put the event on your website and any other website your target audience frequents. For example, in the Mid Atlantic area, www.proaging.com has an event section where professional events can be posted free of charge. Use social media like Facebook, Linkedin and Twitter to announce the event to your followers and colleagues.

• Secure your speaker and other vendors. Contract with speakers, caterers, and entertainment as soon as possible. If you are planning to offer professional continuing education credits, it is important to ensure the speaker can accommodate this early on.

• Choose a “snow date”. Every region has its own weather challenges. If your event is scheduled during a time of year when hurricanes, snowstorms, or other weather calamities may occur, it is best to have a “snow date” scheduled ahead of time and specified on the invitations. Be sure all vendors, speakers and staff understand they are obligated to work on the “snow date” if the original event date must be cancelled.

Four To Six Weeks Before The Event

 • Decide how parking will be handled. When a senior living community has limited parking, it may be wise to hire a valet service. Arranging for parking in nearby lots may be an option as well. Even when parking is plentiful, staff should be asked to park as far from the entrances as possible so guests get premium spots.

• Confirm RSVP’s as they come in. When you receive an e-mail or voicemail in response to your invitation, get in touch with the guest within 48 hours to confirm.

• Plan how to display your community’s strengths. Identify your organization’s strengths and plan how to show them off at the event. Professional referral sources want to be able to tell their clients and patients as much about you as possible. What do you want your guests to remember most about your community?

If your community has delicious gourmet food, showcase that food. If food is not your strength, have the meal or refreshments catered. While some communities offer excellent meals to their residents, they may not have the staffing to handle special events as well and that’s okay. Just don’t count on your culinary staff to seamlessly provide the event meal if they are not equipped with enough time or manpower to also serve the residents.

If your community has outstanding rehab services, highlight that feature during your event. If your clinical outcomes are excellent, make sure your nursing director is available to discuss that in more depth.

The Week Before The Event

 
• Inform staff. Be sure everyone in your community knows there is going to be an important event held and in which rooms it will be held. When employees appear clueless on the event day, it sends a very negative message to guests.

• Provide good directions. Make sure the receptionist and anyone who may answer the telephones knows how to give clear directions to callers. Busy professionals become frustrated when they call to clarify on which street they should turn and they are put on hold for five minutes. When a professional referral source arrives after being lost for twenty minutes they are not entering with the most positive mindset to evaluate your offerings.

• Verify availability & accuracy of brochures.  Be sure your marketing materials are up-to-date with accurate information about pricing, services and clinical outcomes.

The Day Before & Day Of Your Event

• Remind all staff. Once again, remind employees of the event, how parking will be handled and review directions again for anyone who may answer the telephone.

• Remind your attendees. Send a reminder e-mail the day before and call to confirm. This dramatically decreases the likelihood of no-shows.

• Post signs.  If your community is a large, campus style or has multiple entrances, be sure to post signs on where to park and which entrance to use.

•  Make sure your community is immaculate.  While most senior living communities strive for high standards of cleanliness, it is important to put extra effort into high-traffic areas like bathrooms and hallways on event days.  Also, be sure model apartments or rooms look as attractive as possible.

•  Prepare the reception desk.  Be sure the front desk is prepared to greet people on time and even earlier than the expected beginning arrival time. Someone always arrives early.

•  Make sure the event room is set up well ahead of time.  When tables and chairs in the event room are being set up as guests arrive, it is awkward.

•  Display literature about your community.  Make sure there are plenty of copies available for attendees to take back to their offices.

• Tour as many attendees as possible. Frequently communities host events but their guests never see the features and benefits they can offer to potential patients and clients. If you want to show off your new dementia unit, pool or rehab center, make sure your guests have an opportunity to see it and ask questions.

One To Seven Days After Your Event

• Follow up with your guests. Once you have hosted an event, make sure you follow up with as many attendees as possible. Thank you notes, especially handwritten ones, stand out in this day and age. Even a personal e-mail thanking the professional for her attendance distinguishes you. Make follow up appointments for a personal tour if the person did not get to explore your community. Ask what you can do to make the referral source’s job easier in referring appropriate patients and clients to your community.

•  Begin planning your next professional event. Once your community is known for hosting quality networking or educational events, word gets out. Even if your first event is on the small side, take advantage of the momentum by planning your next one. It may take some time to build up attendance, but it is well worth the time invested. Professionals’ increased understanding of your services through regular visits to your community will translate to more qualified referrals.

Ultimately hosting a professional event is not just about showing off your community on the date of the actual event. A well-planned event offers multiple marketing opportunities for your community over several months, both before and after the event date. When the above tips are appropriately applied, there can be to 3-6 contacts with each individual referral source which builds trusting ongoing referral relationships. These relationships strengthen your community, make jobs easier for healthcare providers and most importantly positively impact elderly patients, clients and their family members.

Caregivers experience more illnesses and injuries than their counterparts in the same age group who are not providing care to dependent loved ones.  Once a family member commits to care for an older loved one, it is common for the caregiving to consume that person’s life.  Eventually some caregivers believe they are the only ones who can care properly for their family member.  Tunnel-vision takes over and caregiving becomes their identity.

Unfortunately, more often than not, caregivers do the job alone, without significant help from others.   There are major consequences to being a caregiver, particularly a solo provider.  Caregivers and those who love caregivers need to understand that too much selflessness leads to martyr syndrome.  Martyr syndrome occurs when caregivers experience negative consequences in multiple areas of life as a result of caregiving.

Physical Consequences

Often the first symptom of caregiver martyr syndrome is physical problems.  The caregiver may struggle with headaches, stomach problems, muscle tension and excessive fatigue.  The caregiver is likely not sleeping or eating well.  Exercise has gone out the window.  Ironically, while this is happening the caregiver is often focusing intently on the physical medical problems of the older loved one.  Instead of seeking help from the doctor, caregivers are frequently cancelling and rescheduling their own regular check-ups. 

Financial Consequences

Even if an elderly loved one is completely financially independent, caregivers may find themselves struggling with financial concerns.  A caregiver employed outside the home is more likely to reduce hours or even consider resigning or retiring early to ensure care for the loved one remains uninterrupted.  When the older loved one has limited financial resources, the caregiver frequently will pay for necessities and even some luxuries that will improve quality of life for the caregivers.  This obviously reduces necessary funds for the caregiver’s immediate family.

Spiritual Consequences

Most Americans describe themselves as spiritual, religious or both.  Caregivers regularly experience interruptions to their plans for religious services or spiritual routines.  Some caregivers experience these issues more subtly than others.  For example, a Catholic caregiver whose Sunday Mass schedule is interrupted because of her mother’s needs may notice before a caregiver who has gradually stopped meditating regularly.  People rely on spiritual practices like yoga, meditating, prayer and religious services to help them deal with stress, uncertainty, and to increase inner strength.  While caregiving, people need their spiritual practices more than ever, but during this time they are likely to be abandoned or minimized.

Social Consequences

If a caregiver cannot remember the last time she did something fun with friends or family, social consequences have developed.  Is the caregiver turning down lunch or dinner invitations with others?  Perhaps the caregiver is taking care of her husband and she doesn’t want to go out without him, worried about being a third wheel with other couples.  Caregivers who have abandoned previously enjoyable activities like golf, biking, movies, book club or playing cards are in the process of isolating themselves. 

Social Consequences

If a caregiver cannot remember the last time she did something fun with friends or family, social consequences have developed.  Is the caregiver turning down lunch or dinner invitations with others?  Perhaps the caregiver is taking care of her husband and she doesn’t want to go out without him, worried about being a third wheel with other couples.  Caregivers who have abandoned previously enjoyable activities like golf, biking, movies, book club or playing cards are in the process of isolating themselves. 

Emotional Consequences

Caregivers often experience feelings of anger, resentment, guilt, frustration, sadness and loneliness.  Caregivers who are feeling bombarded by negative feelings on a daily basis, especially when they don’t acknowledge or discuss them, are likely suffering from martyr syndrome.

Psychological Consequences

Caregivers with a history of mental health concerns like depression and anxiety disorders find themselves susceptible to increased symptoms while providing care for a loved one.  Even those who have sought treatment for such conditions may find themselves struggling with the trigger of caregiving stress.  Because of their responsibilities, caregivers can be reluctant to seek treatment, even when they know that old symptoms are flaring up.  The stress of caregiving can also trigger new diagnoses.  Since caregivers are focusing on their loved one’s medical issues, contacting a doctor about new mental health symptoms is often a low priority.  Denial, particularly for those who have never suffered with a mental health concern previously, also contributes to the lack of seeking treatment.

How To Help

It can be a challenge to pull a caregiver from the depths of martyr syndrome. Often caregivers are in denial about their “over-commitment” to caregiving.  A useful exercise for the caregiver can be carefully considering each consequence category: physical, social, financial, spiritual, emotional, and psychological.  Listing any issues he or she is having within each category can be a helpful step to facing reality.

If the caregiver is not open to doing this, friends and family members can gently point out the areas of concern.  When friends and family members do this along with an offer to reduce the caregiver’s load, it can sometimes be effective.  Friends and family must understand, however, that it may take several offers of help before the caregiver accepts.  It can be very difficult for some caregivers to let go and begin to free themselves from martyr syndrome. 

Another option is to enlist the help of other professionals who may be able to convince the caregiver to lighten the load.  Friends and family can always contact the caregiver’s physician, financial planner, clergyperson or psychotherapist to share their concerns.  While these professionals won’t be able to share information back with the friends and family due to confidentiality, often they are willing to accept information about the caregiver.  Caregivers may take a warning from a professional more seriously than they will from friends or family. 

If friends and family members of a caregiver are unable to offer direct help, there are many resources in the community that can provide hands-on help to a caregiver.  Each of the following national organizations can link a caregiver to local services all over the country:

www.n4a.org  links caregivers to local city and county Area Agencies on Aging.

www.alz.org links caregivers to support groups and services for those dealing with permanent dementia diagnoses.

www.nadsa.org links caregivers to adult day care centers in the community.

www.caremanager.org links caregivers to private geriatric care managers, typically nurses and social workers, who assist with managing care of an older loved one.

Senior caregiving is a noble undertaking but is not a job for one person.  What happens to the older patients when their overextended caregivers are hospitalized or even die prematurely?  In order to prevent this common scenario, it is critical for caregivers to free themselves from the martyr syndrome.

Sometimes when working with family members caring for loved ones with permanent dementia like Alzheimer’s disease, I suggest they see three movies released in the past seven years.  In addition to The Savages, I recommend The Notebook (2004) and Away From Her (2006).  While fictional, I believe these films have the potential to significantly enhance the caregivers’ understanding of dementia and how to best help their loved ones.

The scene described above in The Savages is a classic example of caregiver burnout.  Caregivers suffer from more illnesses and premature death than their counterparts not engaged in caregiving.  Sometimes when caregivers see themselves in the Laura Linney character, they recognize that they can’t do it all.  They will consider taking a step back, taking better care of themselves and asking others for support. 

The Notebook’s James Garner reading to his wife demonstrates the excellent use of reminiscing as a way to connect with a loved one whose short term memory is minimal but long term memory is still intact.  Viewing these scenes can help reinforce that discussing happy memories from the years gone is a positive way to connect with a person whose mind resides in the past.

In the film Away From Her, Julie Christie plays a wife with dementia who asks her husband to place her in a memory care unit.  Certainly a request like that is almost unheard of in real life (this is still fiction, after all).  But the portrayal of Julie Christie’s character becoming romantically interested in another patient with dementia is an experience many spouses deal with as part of this disease.  These scenes can help caregivers accept the personality changes that frequently accompany dementia.

 Obviously I recommend books like The 36 Hour Day, resources from the local Alzheimer’s Association (www.alz.org), support groups and educational seminars.  But to augment that, I find that many caregivers find films such as The Savages, Away From Her and The Notebook can be a gentler way to face the tough reality of dementia.