Handling neurological disorders among elderly

ARETHA CLARKE

According to the social work dictionary, a caregiver is someone who provides physical, emotional and social needs for someone else, who is often dependent and cannot provide for his or her needs.

Typically, a caregiver is someone who cares for an elderly parent/relative, children with disabilities, special needs clients and/or people with mental disorders or neurological challenges. In TT, caregivers need to make informed decisions about the care options for their clients, who are physically disabled and have chronic diseases. A person with chronic diseases has abnormal behaviours and abnormal medical conditions that have developed and persisted over a long period of time. Many experts have listed “chronic” conditions as those that last beyond six months and “acute” conditions as medical and behavioural conditions that last less than six months.

Typically, most but not all caregivers experience burnout, with the exceptions of those who have an exceptionally good support system. Caregiver burnout is as a result of on-the-job stress and frustration, where caregivers have more responsibilities than control. During this covid19 pandemic, the roles and responsibilities of caregivers are causing serious increases in mental and health factors among the caregivers, inclusive of burnout.

Since caregivers have major roles and responsibilities and owing to their commitment to the job, many of them refuse to stay away from their clients or relatives for an extensive period of time, which can be extremely damaging to their mental and physical health. This can be further challenging if the client or relative has a neurological disorder, which is a dysfunction of the Central Nervous System (CNS) caused by an injury, disease or drugs. Such disorders can be Parkinson’s disease, cerebral palsy, epilepsy, dementia etc.

Dementia is the most common mental illness among the elderly in TT and it is usually characterised by memory loss, personality change and impaired judgment to think systematically. Dementia is also caused by physiological changes such as stroke, Alzheimer’s disease, substance abuse, medical conditions and/or multiple aetiologies (cause of a disease or condition). Dementia can be both progressive and degenerative. Progressive is where the illness spreads to other parts of the body and affects many body functions. Degenerative is where the illness gets continually worse and causes a greater loss of mental and physical health and abilities, which can cause death.

Alzheimer’s disease, also known as Senile Dementia Alzheimer’s Type (SDAT), is characterised by confusion, forgetfulness, mood swings, impaired cognition to learn, disorientation and dementia. Alzheimer’s disease has seven stages.

• Stage 1: No impairment. Alzheimer's is not detectable and no memory problems or other symptoms of dementia are evident.

• Stage 2: Very mild decline.

• Stage 3: Mild decline.

• Stage 4: Moderate decline.

• Stage 5: Moderately severe decline.

• Stage 6: Severe decline.

• Stage 7: Very severe decline.

Strategies used for better communication with people with Alzheimer’s disease:

• Always approach them from the front and do not startle them.

• Determine how close the client wants you to be.

• If possible, communicate in a calm place with little background noise and distraction.

• Always identify yourself and call the client by his/her name correctly.

• Speak slowly, using a lower tone of voice than normal.

Caregivers increasingly provide essential support to their clients or relatives. However, during the covid19 pandemic, there can be some steps to take in order to reduce the risk of spreading covid19 to the differently-abled, elderly and mentally challenged persons.

These include:

• Postpone your visits if you are exhibiting any symptoms of covid19.

• Consider alternate ways to connect when possible such as phone or video calls etc.

• Always wear your mask during visits to the elderly, and if you are the caregiver always keep your mask on.

• Wash you hands regularly as a visitor and as the caregiver.

Aretha Clarke is the programme co-ordinator at the Ageing Unit, under the Division of Health, Wellness and Family Development, Tobago House of Assembly.

Phone: 639-3395 ext 47207-47208

Website: www.dhwfd.gov.tt

Facebook: Division of Health, Wellness and Family Development