Avenidas’ 16th annual Caregiver Conference, this year with the theme “Caregiving Reimagined,” drew a sizable a crowd to the Mountain View Senior Center Sept. 28.
The hundreds of participants could choose to attend three of nine workshops focusing on self-care, dementia care, family role reversals and more. Dozens of vendors introduced services ranging from senior residences to home-care help and preserving loved ones’ life stories on audio. Following the workshops and a lunch provided by BridgePoint at Los Altos, a Caregiver Cafe enabled participants to share their experiences.
Dr. Mehrdad Ayati kicked things off with a keynote address on “Aging, Challenges, Future.” He said that while people over age 60 made up 8% of the population in 1950 and 10% in 2000, by 2050 the number is expected to jump to 21%. The trouble begins, he explained, when that chunk of the population gets to 80 or 85 and needs more care – and there are fewer younger people to provide it.
Ayati, a geriatric medicine physician, said that over the next 10 years, more and more caregivers will be coming from other countries. Noting how other countries are experiencing the same phenomenon, he said that under Germany’s new immigration policy, skilled caregivers are given first priority, before skilled tech workers.
Ayati also focused on medicalization in America, asserting that overmedicating and unnecessary lab tests and procedures are doing patients more harm than good. He illustrated his points with anecdotes
ranging from his own grandmother’s life without doctors or medicine to playwright Anton Chekhov’s final moments. Chekhov, realizing he was dying, called for a doctor; after assessing his condition, the doctor ordered a bottle of champagne, a glass of which Chekhov drank before dying peacefully. Ayati also shared a comic showing a doctor and patient in an examination room. “The problem is that you’re overmedicated,” the doctor said. “Luckily, there are drugs that can help with that.”
Rather than endless medical tests and drugs, what is really needed is more training in geriatric care for doctors and nurses, Ayati said. In the U.S., the current norm is spending less on social services and more on health care – after people become ill.
One in nine people age 65 and over has dementia, he said, with many more undiagnosed. He proposes cutting back on unnecessary and ineffective drugs, medical treatments and procedures, and using that money to pay family caregivers in order to keep seniors home, where they want to be.
In her presentation “Because You Are Worth It: Self-Care,” gerontologist Alexandra Morris of the Alzheimer’s Association drove home the necessity of self-care for caregivers. Stress and self-neglect, she said, can lead to an erosion of health and well-being to the point of being unable to care for another and needing someone to take care of you – and can even lead to death.
Key to a caregiver’s health, she said, is letting go of unhelpful thoughts, such as “I should have known better,” “I should do more” or “He should be able to do that.” Avoid black-and-white thinking and overgeneralization. Notice the messages you’re sending yourself; if they’re derogatory, gently push them away. Morris also suggested embracing the healing power of sadness for short periods of time, spending time outdoors, practicing breathing exercises and engaging in five enjoyable activities per day.
According to Morris, caregivers need to take breaks without feeling guilty, take advantage of available resources, eat well, exercise, socialize and accept help, with an emphasis on the latter. If a friend or family member asks if there’s anything they can do to help, say “yes.”
Along the way, Morris recommended several books for caregivers: “Alzheimer’s, A Love Story” and “A Curious Kind of Widow” by Ann Davidson, “The Mayo Clinic Guide to Stress-Free Living” by Amit Sood and “Forgive for Good” by Fred Luskin.
The workshop “Being in the Moment: Dementia Care Re-Imagined,” presented by Emily Farber, director of social work at the Rose Kleiner Center, delved into techniques for effective communication and provided dos and don’ts for caregivers, including the following.
Do: give short, one-sentence explanations; allow plenty of time for comprehension; repeat instructions or sentences exactly the same way; avoid insistence; agree with them or distract them to a different subject or activity; accept the blame when something’s wrong; leave the room to avoid confrontations; respond to the feelings rather than the words; be patient, cheerful and reassuring; and practice 100% forgiveness.
Don’t: reason; argue; confront; remind them they forget; question recent memory; take it personally.
You can’t control memory loss, Farber said, only your reaction to it. If the dementia sufferer says hurtful things, remember: It’s the disease talking.
Farber recommended visiting the Alzheimer’s San Diego website at alzsd.org/resources/resource-library for more tips on communication strategies.
For more information on adult day programs offered by the Avenidas Rose Kleiner Center, call 289-5499 or visit avenidas.org/care.