Caregiver counseling and support

The major needs of informal caregivers of people with dementia can be classified into two main categories: (1) optimizing the care of the individual with dementia in terms of information and knowledge, supporting the individual in activities of daily living and dealing with behavioural and psychological symptoms, and (2) responding to personal needs pertaining to care’s own physical and mental health, and life management. Educational programs for informal caregivers, provide information about dementia, legal and financial advice and offer potential practical solutions for dealing with challenging behaviours and stress management. Support groups for informal caregivers led by dementia experts improve caregivers’ mood and ease their emotional burden for approximately three months after program termination. Factors that are crucially involved in the success of such groups include theoretical foundation of the intervention, active role of participants, providing space for presenting and thoroughly discussing individual problems and developing individualized strategies for the management of problem behaviours. Cognitive-behavioural interventions promoting cognitive reframing and skills training contribute to the amelioration of depressive and anxiety symptoms as well as stress feelings of people looking after individuals with dementia. Multicomponent interventions combing dementia-specific education, cognitive behavioral strategies, communication and skills training, coping strategies, environmental modification, and use of assistive devices have been reported to be particularly effective.

As dementia symptoms progress discussing with people with dementia becomes a thorny issue especially in the light of the common burnout and demoralization feelings of caregivers.  Nonetheless, respecting the right of a person to be heard, to pose questions and to receive answers belongs to the basic social rules. Active listening is underpinned by appreciation of the person that we are talking to and is one of the backbones of good communication. Active listening presupposes stopping all other activities and participating attentively to the dialogue. Avoidance of interrupting people with dementia, minimization of common destructions such as radio or TV playing, proper eye contact with the person with dementia facilitate communication too. Summarizing what has been mentioned, confirmation that people with dementia are correctly understood, head shaking or asking them to repeat what they said, clearly indicate they are being listened. Turning away or murmuring are contra productive ways to say no or to express disapproval.  In addition, it is of paramount importance for the communication with individuals with dementia to speak clearly and slowly, to use short and not complicated sentences, to provide sufficient time to respond and to speak for themselves.  Communication in dementia is many cases scourged by language disturbances such as word-finding problems and impaired comprehension for abstract and complex conversation.  Augmentative and alternative communication can be used to compensate for speech disturbances. Augmentative aids, such as pictures and symbols, communication boards and electronic devices are valuable in helping people to express themselves, and facilitate communication.