Serving as the primary caregiver to someone with Alzheimer's disease can take a heavy toll and lead to burnout. In this Q & A from a recent issue of the Johns Hopkins Memory Bulletin, Dr. Peter V. Rabins gives advice to a worried wife.
Question. My husband was diagnosed with early-onset Alzheimer’s disease when he was 59; he is now 65. He had been doing really well and I’ve been able to keep him home. However, in the last month, Kostas has been having problems. From being someone who had a great appetite, he now hardly eats anything. It’s also difficult giving him his Alzheimer’s medication.
Because I am now not sure whether he will do the simple things I ask him to do, I rarely take him to the store and other places we used to go to together. Over the past three years, I have been helping Kostas bathe, but now he refuses to bathe. My problems, then, have to do with Kostas’s lack of interest in food, as well as how to get him to take his heart and Alzheimer’s drugs and what might I be able to do to get him to bathe. Any suggestions would be welcome. Abilene, TX
Dr. Rabins answers. This is a difficult set of problems. If you are struggling with all these challenges alone, I urge you to look into getting help and support from family, friends, a social support agency, the Alzheimer’s Association, as well as a dementia specialist.
If some of these problems have developed quickly, consider whether a second issue such as depression, a new medical illness, or medication side effects is partly to blame. If swallowing difficulties are contributing to the problem your husband is having in taking medication, ask his doctor whether his medications are available in liquid form or as rapid-dissolving tablets. The bathing problems you describe become common as Alzheimer’s progresses; if no other cause is identified, consider getting bathing help from another person (family or paid aide), decreasing the frequency of the baths, or giving him sponge baths from time to time instead of a regular bath.
Editor’s note: Peter V. Rabins, M.D., M.P.H. is Medical Editor of the Johns Hopkins Memory Bulletin and Professor of Psychiatry at the Johns Hopkins School of Medicine. His best-selling guide for caregivers, The 36-Hour-Day, has provided support to countless thousands struggling to cope with the demands of caring for a loved one with Alzheimer’s and other dementias.
