INCONTINENCE AND OTHER CARE ISSUES SPECIFIC TO ALZHEIMER'S DISEASE
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Tom in London, 1983. Tom and Beverly, 1994. From Beverly Murphy: I want this web page to be a forum where caregivers can come together to share some of the quality moments that happen in the care of a family member with Alzheimers. I also feel we caregivers need a place where we can air the affect the public has on us when they say the things that dont help and often hurt. I know, even with all my experience, and being the sort of person who almost automatically asks; "Why Not!," when someone tells me I cant do something I feel in my gut is doable, I also fell victim to the standing rhetoric. And then one day I listened to the words being spoken and separated them from the emotion they carried and I realized that most of the answers I got to the questions I asked werent really answers at all, they were merely empty clichés. Over the past four years I compiled a list and I share this with you. I welcome your comments and perhaps you will share some of your favorite non-answers with me and I will share them with those who tap into this web page.:
Do You Know This About Alzheimer's? Letter From Beverly Bigtree MurphyDear Caregivers,I am first and foremost a caregiver, having cared for my husband Tom in our home until he died of Alzheimers Disease in October 1995. I also had 25 years experience as a counselor, designing training programs and altering environments for handicapped people as a Certified Rehabilitation Counselor. I taught, as adjunct faculty, in the graduate Department of Guidance and Counseling, City University New York for several years and have led numbers of support groups both as a part of my function as a counselor and now as an advocate for family members facing Alzheimers disease. However, even with all that experience and a Masters degree to proclaim my credentials as a professional, nothing prepared me for the reality I faced as my husbands symptoms developed. Like everyone else, I grew into my role as caregiver learning to draw from resources I didnt even know I had. While I was able to find strength in my resourcefulness I also felt the isolation that took over. It was a fairly solitary 10 years for me but I did come away with certain revelations.
The one constant Tom needed most was to feel safe and loved. It was Tom who encouraged me to write this book and it was Tom, who unwittingly, gave me the title. The words not only expressed his own frustrations at his losses, but they expressed how both of us were treated by those who witnessed those losses. My experience ultimately belied the rhetoric about this illness and that is what I tried to relate in this book. This is the book I wish I could have read when Tom and I started on this journey. I began each chapter with the lyrics to our favorite songs and the poetry expressed in the songs speak to a time when commitment, unconditional love, and sacrifice were thought to be positive qualities. My experience proved to me that those qualities still have a place in our lives and their power to strengthen in times of great need should not be underestimated. Ours, after all, was still a love story. Beverly Bigtree Murphy
Do You Know This About Alzheimer's? Contrary to belief, the majority of care is not done in nursing homes. According to the National Alzheimers Association statistics, 75% of the care is being done at home, usually by a family member. That translates into 3,000,000 out of the 4,000,000 who have this disease, at home with a lone caregiver, who is isolated, left with few resources, little encouragement, and someone who watches a great deal of television. The remainder of care is done with a combination of family/private pay, group homes, supported living arrangements and nursing homes. Less than 10% of the care is done in nursing homes. One has to wonder why home care is the best kept secret in the movement. National television and the media at large has yet to address the positives that exist in the home care choice for Alzheimers families. No one ever talks about how rich the last years with an Alzheimers person can be. No one ever acknowledges their needs for nurturing, security, acceptance, or their ability to give love back. No one ever characterizes their caregivers in positive or life giving terms. Instead, only the most negative aspects of this illness are ever presented and the only message the public gets is one of hopelessness and rationalized abandonment. Not one show has even offered home-care as an option. One has to wonder if our official spokespeople, who either made the nursing home choice for their Alzheimers person, or who never faced this illness in their family, and who routinely appear on these shows, can give an unbiased, informed picture of this disease to those of us, (the 75%) who are struggling to maintain our people at home. Our people are routinely stripped of their worth as human beings because they lose their ability to think and communicate. That is discrimination at its worst. It is nothing less than bias that is so accepted it isnt even recognized as bias. People in comas are afforded more regard than are those with Alzheimers. As a result, caregivers, who ignore the rhetoric, who see continued connection, who honor their commitment, who struggle alone, are smugly characterized as symbiotic, martyrs, co-dependent, potential abusers, or saints, depending on who is casting the role, and thats everyone from doctors to uninvited strangers. Our people are dismissed as having no valid reason to live, but they do live, for years until this disease kills them, and Im not sure euthanasia or institutionalization is any more valid a solution to their care needs than it is for a developmentally disabled child. One has to wonder why this death justifies the withdrawal of love.. Those who make the nursing home choice arent being dealt with properly either. Guilt is too easy a label to fling at people experiencing grieving. While they mourn the losses, they also feel a sense of failure, no matter how irrational, that goes hand-in-hand with the nursing home choice. Telling family members to not feel guilty, really doesnt help them much and it trivializes the enormity of their choice. In comparison, we home-caregivers more often come out of our experience with a sense of accomplishment and peace, partly because we dont miss the moments left to share. We also find the tasks are merely tasks, they dont reflect on who we are as human beings. What home-caregivers feel is fatigue and abandonment. What we dont feel is a sense of failure. One has to wonder if more would find a sense of accomplishment in their caregiving if the stigma of Alzheimers was removed and more options and support were offered. The end-stage home-care tasks arent different from any other terminal or chair-bound person. While our caregivers face a myriad of problems unique to this disease during the early stages, with information, basic skills, respite and a positive attitude the care needs can be met at home until death. The horror of Alzheimers is really about communication, unresolved issues, and mourning what should have been, but those issues face everyone with terminal illness. Unfortunately, people dont resolve issues even when they can talk to each other. One has to wonder how so many of us find resolution and closure in relationships once thought to be insurmountable in spite of the communication barriers. Alzheimers is probably, the only illness that can truly be described as being the opposite of birth. The Alzheimers brain shrinks as the disease progresses and the layers of learning are stripped away in much the same order in which they were laid on from birth. At death, the brain resembles that of a newborn infant. Emotion, the first thing a newborn experiences, is necessary for their survival and bonding instincts. Emotion is the last thing an Alzheimers person retains. They respond to love, nurturing, acceptance, touch, body language, inflection in voices until the moment they die. If our caregivers have a mission it is to help their family member regress with the same respect they afford an infants development. I ask you, how do caregivers recognize the ramifications of their role, how do they face this challenge if the only message they get is: "You cant do it," and more important: "You are crazy to try!" One has to wonder if it really matters if our people know who we are when we still know who they are. |
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