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Counseling For Alzheimer’s Caregivers

Find Out What Your Health Insurance Covers

The NYU Caregiver Counseling and Support Intervention

Many health insurance plans cover therapy and so does Medicare. If you have a plan that includes mental health services like therapy, then its worth first looking into the therapists in your area that are covered, so youre not spending more than you have to.

If your health insurance doesnt cover mental health at all or only has a limited network, dont worry. A lot of therapists provide a sliding scale to help people with limited incomes better afford it.

Stages And Components Of Caregiver Family Therapy

Evaluation of the Person Who Is Impaired and Family SystemTherapy begins with detailed interpretation of medical, neuropsychological, and functional assessment information to all family members engaged in decision-making roles . Key safety risks, family decision-making processes and role structures, and caregiving burdens are identified.

Problem-Solving Immediate Risks and Identifying Formal ResourcesPractical recommendations to modify care environments and services are offered to address immediate and long-term safety risks.

Family RestructuringFamily members are engaged in a reevaluation of their roles and decision-making structures to determine what functions need to be fulfilled by different members, and how the person with dementia can be engaged in the process. Often, persons with dementia deny the extent and impact of their impairments and attempt to maintain decision-making authority that places them at risk. Family members are coached in establishing new functional decision-making structures while engaging the person with dementia in interactions that respect capabilities.

Caregiver Self-CareThe caregiver’s capacity to sustain instrumental and emotional care services is assessed continuously, and he or she is coached in developing support relationships and providing services. As needed, caregivers are taught knowledge and skills useful to their role and self-care skills to maintain individual development in the midst of the demands of caregiving.

Getting Help With Alzheimer’s Caregiving

Some caregivers need help when the person is in the early stages of Alzheimer’s disease. Other caregivers look for help when the person is in the later stages of Alzheimer’s. It’s okay to seek help whenever you need it.

As the person moves through the stages of Alzheimer’s, he or she will need more care. One reason is that medicines used to treat Alzheimer’s disease can only control symptoms they cannot cure the disease. Symptoms, such as memory loss and confusion, will get worse over time.

Because of this, you will need more help. You may feel that asking for help shows weakness or a lack of caring, but the opposite is true. Asking for help shows your strength. It means you know your limits and when to seek support.

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Preserving Your Loved Ones Independence

Take steps to slow the progression of symptoms. While treatments are available for some symptoms, lifestyle changes can also be effective weapons in slowing down the diseases progression. Exercising, eating and sleeping well, managing stress, and staying mentally and socially active are among the steps that can improve brain health and slow the process of deterioration. Making healthy lifestyle changes alongside your loved one can also help protect your own health and counter the stress of caregiving.

Help with short-term memory loss. In the early stages, your loved one may need prompts or reminders to help them remember appointments, recall words or names, keep track of medications, or manage bills and money, for example. To help your loved one maintain their independence, instead of simply taking over every task yourself, try to work together as a partnership. Let your loved one indicate when they want help remembering a word, for example, or agree to check their calculations before paying bills. Encourage them to use a notebook or smartphone to create reminders to keep on hand.

Counseling Support Aid Alzheimers Caregivers

Dementia Care

Counseling, support aid Alzheimers caregivers

Relieving harmful stress and depression is the goal

A combination of counseling and support services may reduce the risk of depression in people caring for a spouse with Alzheimers disease, a new study says.The study, published in the May 2004 issue of the American Journal of Psychiatry, also suggests that giving spousal support might help people who are not clinically depressed, but who endure the chronic stress of caring for someone with the progressive brain disease.

Other research suggests chronic stress might damage the immune system and put caregivers at risk for diseases such as cancer.The study began with the experiences of two elderly counselors who had started providing informal help to spouses in the hallways of New York Universitys Alzheimers unit.

“We noticed that caregivers often looked very upset and bewildered,” explains NYU counselor Emma Shulman, who, at age 91, has plenty of life experience and a degree in social work to help her provide guidance to others.Shulman and her colleague, 84-year-old Gertrude Steinberg, began to offer advice to spouses who were caring for a partner with Alzheimers disease.

Counselors can help caregivers minimize the behavioral difficulties caused by the disease. People with Alzheimers can become aggressive and lash out at a family member. “This is a very difficult disease to live with,” Mittelman says.

Tips for caregivers include:

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Geriatric Medical Assessment & Caregiver Problem Solving

Often families find themselves at a loss when caring for a loved one living with dementia. So many variables the causes and the symptoms lead to challenges that can overwhelm caregivers. Many resources exist, but may not address your specific situation.

We Offer a Solution

We offer personalized one-to-one educational consultations to help you navigate your challenges and learn approaches that may resolve difficult situations with our experts in dementia, Elizabeth Landsverk MD, Tami Anastasia, and Alexandra Morris.

Provider Specialties

Choose the best provider for your situation. Schedule your consultation below.

Medical, Behavioral, Functional, and Pain Problem Solving

Elizabeth Landsverk MD

MEDICAL, BEHAVIORAL, FUNCTIONAL AND PAIN PROBLEM SOLVING

Care For The Caregiver: Care Counseling

A list of 800 phone numbers and three booklets didnt help me in the least. I needed someone to actually talk to meto stay with meto help me figure out what to do as everything was closing in around me.

This comment could have come from any of the 90 million family caregivers in the U.S., but it comes from Anne, who lives in Maryland. Annes parents, who are in their mid-80s, moved to Florida more six years ago. Annes mother, Jane, is the primary caregiver for Annes father, who suffered a stroke and subsequent mild dementia. Because Anne is also caregiver for her own husband, she is well informed and tries to anticipate problems. Anne located a geriatric care manager in Florida, and asked for help in reviewing the parents paperwork. After looking over the documents, the care manager helped arrange a family meeting to consider changing legal needs. Because of the planned meeting, Anne and her spouse, her brother and his wife were all in Florida with the parents. Then the crisis struck.

My father fell and broke his hip, and had to be hospitalized. Because of anesthesia and other complications, he became much more argumentative, his incontinence worsened, and the dementia seemed to be increasing. We knew my Mother couldnt care for him by herself any longer, and now we had to find a place where he could be safe and she could be nearby.

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The Dangers Of Caregiver Burnout

Many family members go through periods of sadness and frustration while caring for a loved one. These are normal human responses to the challenges of the situation, and these feelings do not in any way indicate failure or inadequacy in the provision of care. However, a damaging emotional cycle begins when caregiver guilt and anxiety develop over these feelings. Caregivers pour their hearts and souls into their loved ones care, and the stress of this commitment can have unintended emotional consequences.

When asked about telltale signs of caregiver burnout, Shawn Hertz of the Los Angeles Caregiver Resource Center says resentment is a common indicator.

There are quite a few red flags for burnout, including medical, physical, psychological and social symptoms, Hertz explains. Thats the important thing to remember about caregiver stress: it doesnt just affect one aspect of your life. It affects all the major aspects of life that make you a whole person.

Being proactive about minimizing caregiver burden and learning how to handle stress in a healthy way is crucial for succeeding in this role.

Whats The Difference Between Dementia And Alzheimer’s

Alzheimer’s: The Caregiver’s Perspective

Many people use the terms dementia and Alzheimers interchangeably. While dementia and Alzheimer’s certainly have a lot in common, the two words have key differences. Using the correct term to talk about memory loss will help you get the best possible information. Read on to get the facts about both dementia and Alzheimer’s disease…

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Needs Of The Person With Dementia Their Care Partner And

⢠Assistance in Organizing their Day/Schedule

⢠Assistance with Personal Care, Medication Management, ADL’s

⢠Social Support

⢠Opportunities for Reminiscing and Meaningful Conversation and Communication

⢠Ability, Awareness and Opportunities to make Choices

⢠Motivation to Participate in Physical Exercise

⢠Explanation and Understanding when Confused

⢠Redirection when Wandering or Becoming Agitated or Anxious

⢠Intellectual and Sensory Stimulation

⢠Networking Opportunities with other Care Partners

⢠Artistic and Creative Outlet

⢠Respite from Responsibilities

⢠Opportunities to Connect with their Loved One

⢠Support of New Roles in Relationships and Changing Identity

⢠Access to Experienced Professionals in Dementia Care

⢠Coping Strategies

⢠Decrease in Stress and Increase in Overall Wellbeing

Narrow Options Based On Availability And Cost

Now you want to start getting in touch to find out what kind of availability they have and what they charge. If there are one or two therapists that you especially like the look of, start with them and find out if they can fit you into their calendar at times that work for you and if they offer a rate you can afford.

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Importance Of Therapeutic Relationship

An established therapeutic relationship allows the therapist and client to work together towards the aim of achieving the clientâs set goals , and can be expressed in many ways, that is verbally and non-verbally . Parallels can be drawn between the therapeutic counselling relationship and the concept of relationship-centred care in dementia , which emphasises the value of quality relationships to lead to positive change in care encounters. It offers a basis for nurturing interpersonal relationships with people with dementia: the âsenses frameworkâ , giving emphasis to feelings of security and belonging, continuity, purpose, significance and achievement in caring relationships. The sense of achievement resonates with goal attainment in counselling interventions. The counselling practitionerâs role involves âempathic, affirmative, collaborative and self-congruent engagementâ , which therefore should be seen as an equal recipient of feelings such as purpose and significance in therapeutic exchanges. However, in a field where the development and maintenance of a therapeutic relationship is increasingly suggested as a prerequisite for successful therapy , this raises valid questions surrounding best practice approaches to forming impactful therapeutic relationships with people affected by dementia.

The Application Of Set Within The Miami Reach Project

Validation Therapy for Seniors with Dementia

As noted, SET is one of the interventions being evaluated at the Miami site of the REACH project. The participants are randomly assigned to one of the three treatment conditions. The other intervention conditions include SET enhanced with a computer integrated telephone system , and a minimal contact telephone support control. The CTIS system serves to augment the family therapy intervention by facilitating the caregivers’ ability to communicate with family members, friends, other caregivers and their therapist. The participants are recruited from two memory disorder clinics affiliated with the Department of Psychiatry and Behavioral Sciences, and from the community via newspaper and radio advertisement. In almost all cases, it is the primary caregiver who makes the initial call to the project.

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Dealing With The Realities Of Dementia

Licensed professional counselor Ruth Drew oversees the Alzheimers Associations 24-hour helpline, which offers support to those facing the challenges of dementia and Alzheimers disease, including families and caregivers. The fact that the helpline receives more than 300,000 calls each year hints at the heart-wrenching issues that accompany a dementia diagnosis, not just for the individual but for the persons entire support system.

We receive a wide range of questions, from someone worried about the warning signs of cognitive decline or dealing with a new diagnosis, to an adult son whose mother didnt recognize him for the first time, or a wife wondering how to get her husband with Alzheimers to take a bath. Whatever the reason for the call, we meet callers where they are and endeavor to provide the information, resources and emotional support they need, says Drew, director of information and support services at the Chicago-based nonprofit.

Professional counselors are a good fit to help not only individuals with dementia and Alzheimers, but also those in their care networks, Drew says. Whether counseling individuals, couples or even children, the far-reaching implications of dementia mean that practitioners of any specialization may hear clients talk about the stressors and overwhelming emotions that can accompany the diagnosis.

A growing need

Caring for the caregivers

Listen and validate

Still human

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Counselors as caregivers

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Caregiving In The Late Stages Of Alzheimers Or Dementia

As Alzheimers or another dementia reaches the late stages, your loved one will likely require 24-hour care. They may be unable to walk or handle any personal care, have difficulty eating, be vulnerable to infections, and no longer able to express their needs. Problems with incontinence, mood, hallucinations, and delirium are also very common.

In your role as caregiver, youll likely be combining these new challenges with managing painful feelings of grief and loss and making difficult end-of-life decisions. You may even be experiencing relief that your loved ones long struggle is drawing to an end, or guilt that youve somehow failed as a caregiver. As at the other stages of your caregiving journey, its important to give yourself time to adjust, grieve your losses, and gain acceptance.

Since the caregiving demands are so extensive in the later stages, it may no longer be possible for you to provide the necessary care for your loved one alone. If the patient needs total support for routine activities such as bathing, dressing, or turning, you may not be strong enough to handle them on your own. Or you may feel that youre unable to ease their pain or make them as comfortable youd like. In such cases, you may want to consider moving them to a care facility such as a nursing home, where they can receive high levels of both custodial and medical care.

Connecting in the late stages of care

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Make Time For Reflection

At each new stage of dementia, you have to alter your expectations about what your loved one is capable of. By accepting each new reality and taking time to reflect on these changes, you can better cope with the emotional loss and find greater satisfaction in your caregiving role.

Keep a daily journal to record and reflect on your experiences. By writing down your thoughts, you can mourn losses, celebrate successes, and challenge negative thought patterns that impact your mood and outlook.

Count your blessings. It may sound counterintuitive in the midst of such challenges, but keeping a daily gratitude list can help chase away the blues. It can also help you focus on what your loved one is still capable of, rather than the abilities theyve lost.

Value what is possible. In the middle stages of dementia, your loved one still has many abilities. Structure activities to invite their participation on whatever level is possible. By valuing what your loved one is able to give, you can find pleasure and satisfaction on even the toughest days.

Improve your emotional awareness. Remaining engaged, focused, and calm in the midst of such tremendous responsibility can challenge even the most capable caregivers. By developing your emotional awareness skills, however, you can relieve stress, experience positive emotions, and bring new peace and clarity to your caretaking role.

The Importance Of Counseling For Caregivers

Support Groups Offer Haven for Alzheimer’s Caregivers

Although caregiving is a uniquely rewarding experience, it is also a mentally and physically demanding job. Without proper support, it can take a toll on your health and your psyche. Burnout is a family caregivers worst enemy, but utilizing mental health resources can help you achieve emotional stability while providing quality care.

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Uniqueness Of The Counsellor

Direct discussion with the counselling practitioner revealed some personal attributes which shaped the course of the intervention and provided the basis for relationship building with clients.

3.1.1 Practice philosophy

Central to the counsellorâs philosophy to delivering therapy was the underpinning relational approach, applying this to both people living with dementia and their family members in counselling. This consists of modalities that throw light on a different dynamic of interpersonal relationships. There is a focus on the therapeutic relationship, and the key principles of this approach consist of the following:

  • Relations between people are the basis of social and individual life, and relational concepts are used to understand human life in all its complexity.
  • Relationships are of fundamental importance in:
  • The development of personality and a sense of self
  • The difficulties clients bring to therapy
  • The therapeutic process
  • The relational approach is therefore perhaps best considered as a framework that is considered central to virtually all approaches .

    I work with people in the room, whateverâs in the room. So I do work relationally. But⦠there might be times that itâs definitely client-led, there might be times thereâs a bit of TA in there, it really just depends on that client.

    3.1.2 Client-influenced understanding

    Sources Of Affordable Counseling Services

    1. Therapists covered by health insuranceMany large healthcare organizations offer therapy thats covered by their insurance plans.

    Talk with your doctor to get a referral or call your health insurance provider to see if therapy is a covered service.

    2. Free workplace Employee Assistance Programs Many large companies have Employee Assistance Programs where counselors help you deal with life changes and other stressful situations.

    If you havent seen or heard about these programs at your office, check with your Human Resources person. Usually, the company wont be told who uses these services, so you shouldnt be afraid to use the help.

    3. Low cost or sliding scale therapists Many therapists offer low cost or sliding scale fees. Sliding scale means that they charge people differently based on their financial situation.

    Fees range from completely free to around $100. Here are a few options:

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