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END-OF-LIFE
ISSUES

When the twilight years become
The Twilight Zone:

Caregivers can assist physicians who see dementia patients

By Marcy Meffert

When dealing with dementia patients and their caregivers, physi- worse yet, the plate is wearing off. Your love may endure but passion
cians may need the same observational skills used by veterinarians goes and mere memories don’t make the earth move. Caregiving
whose patients communicate only with behavior and appearance. for parents reverses your roles, which can be uncomfortable for both
of you. Caring for both a spouse and a parent simultaneously chal-
Unlike veterinary patients, who can’t talk, many dementia pa- lenges many members of the “Sandwich Generation.” In all situa-
tients can talk but don’t want to acknowledge the severity of their tions, reality hits hard the first time you stop at the drugstore for
mental state by discussing it. They feel betrayed if their caregivers incontinence products. Changing Depends for someone who was
describe escalation of old and appearance of new symptoms. To once your lover or who once changed your Huggies conjures up a
make matters worse, doctors’ appointments don’t always coincide tangle of emotions that keep you awake at night.
with their bad days. On their good days, in early dementia, many
patients fake it well enough in public to make caregivers wonder if CARE BECOMES PHYSICALLY DEMANDING
they are the ones with dementia and are imagining the scary driv- Learning to deal with each phase of any disease is difficult, but
ing, obsessive behaviors, peculiar conversations and memory lapses.
dementia adds a new dimension. As cognitive and physical abilities
Wondering if you are the one with dementia is only a minor decline, caregiving becomes as physically demanding as it is emo-
stress compared to the other frustrations of caregiving. If caregiving tionally draining, and sleep deprivation exacerbates all frustrations.
for a spouse, you have to accept that the golden years, which you Watching someone who once did delicate surgery struggle to use a
expected to enjoy after retirement, have been only gold plated, and

18 San Antonio Medicine • April 2015