Caregiving During a National Emergency
At times of emergency, such as the events of September 11 or Hurricane Katrina, there are so many things to process, one has trouble prioritizing and putting things in perspective. If you are caring for a loved one with dementia, you probably found your attention distracted and your emotions conflicted. Sometimes it was hard to concentrate on the daily things in life, sometimes it was reassuring to do mundane tasks. Often people feel out of control and insecure at times of crisis. Perhaps the suggestions below will help when times are unsettled —for any reason.
People with dementia might not understand what is going on around them. However, they do pick up emotions, might have a partial understanding which has led to greater confusion, and their needs might be overlooked. Although this is understandable, it can increase the problems of the caregiver. Your loved one might be more anxious, less willing to do things, more difficult to distract and have sleep disturbances. Depending on the severity of the dementia, he/she might make irrelevant comments or laugh inappropriately. Since long term memory is generally more intact, he/she might fixate on an earlier time with some similar aspects to the current situation.
There are a number of ways you might be successful in reducing agitation. First of all, do not watch TV incessantly. If at all possible and depending on the level of the dementia, it would be good to avoid having the person with dementia see the TV coverage of the event all together, including radio and newspaper coverage. Everyone should, in fact, limit the number of hours spent watching a disaster. It has been shown that endless watching can in and of itself lead to post traumatic stress disorder. You can talk about the incident with the person in general terms. One caregiver was asked by her husband, "How are things going with the accident?" Although she wanted to scream, "It wasn't an accident," she could say to him that the government was doing everything possible to help the situation. This form of reassurance is important.
Second, it is helpful to maintain routines as much as possible. Routines are reassuring to people with dementia, and they will be calmer if their daily schedule is kept. You might find that keeping a routine is reassuring for yourself as well, allowing you to focus on tasks without too much thinking.
Finally, it is important to take care of yourself. Do not watch too much TV. Gather whatever friends and family you have around you, allow yourself to feel nurtured and connected with others as much as possible. We all feel fragile and insecure in the face of a disaster and we need to find reassurance and connectedness. It can feel particularly lonely when our loved one cannot respond in kind to our needs at times like this. Reach out to someone, attend religious services or log on to a chat room. And please lower your expectations of yourself, slow down, do what feels nurturing for yourself and be very patient with yourself and your loved one. When feeling stressed, our nerves often feel raw and we might find ourselves being snappy or cranky. Forgive yourself for not being perfect; it is understandable under the circumstances.
At the preventive level, it is always good to have a disaster plan at your house. Is there back up for someone to care for your loved one in case you can't make it home? Can someone pick him/her up from daycare? Do you have an extra week of medication stored away in case you couldn't get to the pharmacy in an emergency? Do you keep water supplies and canned foods somewhere accessible? These are things that all people, especially those who live in California earthquake country, need to think about anyway. But given the events of last September, we need always to be prepared for that which we can't control and can't predict. For an emergency preparedness checklist click here.