1. Caregiving: A journey without a map Erin Scott, MD Geriatric Medicine Fellow March 14, 2015

2. Let’s Begin.... There is no perfect way to take care of an elderly parent except with the most love and patience you are able to muster on that particular day.

3. Small Group Discussions

4. Large Group Discussion

5. Safety 90% of community dwelling persons with dementia have unmet safety needs

6. Safety He sometimes falls down. He trips over his own feet or just crumples up. But when I try to lift him - and he is a big man - he yells and struggles against me.

7. Safety MJ refused to stop living alone, although it was clear to his family that he could no longer manage. Instead, he called his daughter at least once a day with real emergencies that sent her dashing across town to help out. His daughter felt angry and manipulated. She was neglecting her own family and she was exhausted. She felt that her father had always been a self-centered, demanding person, and that his current behavior was deliberately selfish.

8. Safety PC lived with her daughter. The two women had never really gotten along and now PC had Alzheimer’s disease. She was wearing her daughter out with demands (get me a cup of coffee, get me my cigarettes). The daughter could not tell her mother to do these things herself because she started fires.

9. Medical Needs More than 60% of community dwelling persons with dementia have unmet needs for medical care

10. Medical Needs Change in routine Fear of doctors Environment

11. Caregiver Stress 5.4 million people in US with Alzheimer’s Disease 70% cared for at home by family and friends

12. Caregiver Stress More than 85% of caregivers had unmet needs for referrals to community resources and caregiver education

13. Caregiver Stress ● Falls ● Pressure Sores ● Sleep Disturbances ● Wandering ● Driving ● Repetitious Actions ● Stealing ● Inappropriate Sexual Behavior ● Depression/Suicide ● Alcohol Abuse ● Paranoia/Suspiciousness ● Delusions/Hallucinations ● Constipation/Diarrhea ● Incontinence ● Personal Hygiene ● Pain ● Appetite

14. Caregivers Stress What can you look for? How can you help?

15. All of you who are out there every day watching your loved one enter the dark woods and know too well that you can not go in there with him, have courage. Be strong when you can, forgive yourself when you can’t, and let go when you must.

16. Questions

17. Thank You