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A narrative of a caregiver of a person with dementia

Caring For A Loved One is A Difficult Journey

The average life expectancy in Hong Kong is 82 years for males and 88 years for females. Approximately 5% of 65 years old elderly suffer from dementia; this statistic increases to 30% in the elderly who are 85 years or older. While we can understand that it is difficult to accept being diagnosed with dementia, we may not be aware of the difficulties faced by dementia caregivers. This article is by Ms Lam, a client of The Companions, who received psychological counselling to care for an elderly with dementia at home. Ms Lam wishes to share her experience to raise awareness of the challenges of caregivers of persons with dementia so that fellow caregivers in a similar plight know that they are not alone.

80-Year-Old Senior Suspected of Having an Affair

“Your father-in-law has an affair with that old lady who made him pay for her meal at the tea house!” my mother-in-law said seriously. I responded: “Father-in-law is already over eighty, surely this is not true?” My sister-in-law overheard our conversation and raised her voice: ” Mum, don’t talk nonsense. Father was only sharing a table with that old lady. Look, you have forgotten to turn off the stove again! It is the third time this week!”

My mother-in-law was entirely convinced that my father-in-law was having an affair. She started looking for evidence, even refusing to sleep at night. No matter how hard my father-in-law tried to clarify, it was futile. When we advised her not to overthink, my mother-in-law would feel that we were not on her side. Thus, resulting in discords and unhappiness within the family. My mother-in-law also started to behave differently. She often mumbled to herself, cried whenever upset and would not listen to those who were coaxing her with good intent. Occasionally, she would also attempt to hit others and had injured my father-in-law. For safety reasons, we suggested that my father-in-law temporarily moved out. However, he insisted to stay put out of his love for my mother-in-law. Every day, we would go home nervously as we do not know if my mother-in-law would have an emotional outburst. Having to watch over both elderly and pacify them when they were emotional draining for us.

We became very worried about my mother-in-law as she seemed to change from a very well-mannered person to a foul-mouthed person who swore offensively. Hence, we decided to bring her to see a doctor and did a magnetic resonance imaging (MRI) scan for her. The scan showed she has Alzheimer’s Disease. When the doctor was explaining her diagnosis to us, my mother-in-law could not accept the news. She kept insisting that her behaviour was due to my father-in-law’s affair and that her occasional poor memory was because of ageing. Eventually, the family doctor referred her to see a psychiatrist in private practice.

The psychiatrist told us that my mother-in-law might have been unhappy with my father-in-law’s frequent social engagements in his younger days, causing her to develop a knot of negative emotion and thoughts that led to delusions about the affair. The psychiatrist advised us to avoid disputing with her. Before her medications could take effect, a serious incident took place. My mother-in-law met up with the “third party” on her own and started a fight, which required the police to intervene. As a result, the psychiatrist suggested that we relocate elsewhere to avoid proximity with the lady. This is a way to minimise a chance whereby my mother-in-law’s condition could get aggravated.

Medical Treatment Coupled With Counselling Bring a Beacon of Light

After moving to a new home, the psychiatrist increased the dosage of my mother-in-law’s medication. She also started to receive counselling. My mother-in-law has become calmer, more cheerful, and often thank the family for taking care of her. However, she remains suspicious. Sometimes, when my father-in-law’s mobile phone rings, she will think that the call is from the “third-party”. She often rummages through my father-in-law’s drawers and tells us that her hidden cash has been stolen. Fortunately, she has fewer emotional outbursts now. We follow the advice of the psychiatrist and counsellor by not disputing with her whenever she experiences

an emotional outburst. We try to divert her attention to calm her down, which works most of the times. Lately, my mother-in-law is having thoughts about not seeing the psychiatrist and stopping her medication. We find out that she is concerned about treatment costs and is worried that we may not be able to cope financially. The counsellor suggests that we talk to her often to identify the cause of her worries and give her positive affirmation that taking medicine is beneficial to her.

As a caregiver, it can be hard to accept that a loved one has dementia. There are drastic changes in the sufferer’s temperament, ways of thinking and behaviour as if he or she has become a completely different person. While medication controls and reduces the effects of the symptoms, it should be complemented with counselling. As the sufferer and family will face numerous difficulties, counselling can support them in managing this illness that is marked by insidious decline until the end of life (currently, there is no cure for Alzheimer’s Disease)

I like to take this opportunity to express my deepest gratitude to my counsellor, who has been coaching me all this while. Thank you, because you are with me on this journey, I feel less lonely during the times when I am at a loss.

Ways in which Psychological Counsellors can help patients who suffer from dementia:

  1. Being there alongside the patient and actively listening without judgement
  2. Give positive affirmations on the benefits of taking medications
  3. Alleviate negative emotions, reduce emotional outbursts
  4. Help patients develop positivity towards what they are fond of, thereby enabling them to enjoy a happier life
  5. Provide group therapy, games, music, art therapies etc., to establish social relations

The Companions
Dr. KK Cheng