Senior Spectrum
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Sept 2008
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Geriatric Psychiatry
Punishing the Caregiver
As a physician I provide care not only to an elderly or disabled patient but to his or her family or caregiver. Persons who develop dementia may lose the ability to care for themselves and become dependent on others. Caregivers come in many forms: spouses, children, friends, guardians, and a host of social and healthcare providers.
Sometimes patients are the least distressed. After all, they are the ones who have lost touch with their own cognitive capacities and have become oblivious to their needs. Persons with the more advanced dementias often don't even know there is a problem. Their world is simplified, regressed to a point of no worries or responsibilities. Indeed, they may be like children, content to eat, sleep, and play.
The stress falls upon the caregivers. Who else is going to see that bills are paid, daily and medical needs are fulfilled, and that the stricken person doesn't wander off in the middle of the night and freeze to death?
More challenging yet is the situation of the caregiver becoming the object of paranoia. The person with dementia, failing to appreciate the circumstances, targets and accuses the person providing help.
“My own son stole my house, took my car, my money. He put me in this strange place because he's ungrateful.” Or, “Because of that no good daughter-in-law (I told him not to marry her in the first place) I am now living in their back bedroom. They're trying to kill me.”
Unfortunately, there are those who will abuse or exploit the elderly. Many, however, are the family and community persons who come to the rescue of the elderly and infirm. In return for their efforts, they receive not gratitude, but assaults and accusations.
Without caring individuals, a lot of sick and old people would be living in unfit conditions, alone, or dead. If it wasn't for the many who adjust their own lifestyles to help others, the number of persons dependent on the increasingly strained social and health care systems would be even greater. To those who sincerely provide care to patients or their family elders, thank you. You are not alone.
Steven Rubin MD
Adult & Gerolescent Psychiatry
geroldoc@hotmail.com