The New Face of Caregiving: Male Caregivers

This article from a recent AARP Bulletin Today is about male caregivers. The seven tips for male caregivers at the bottom of the article certainly apply to all caregivers. John Young, president of the LBDA (Lewy Body Dementia Association) Board, is mentioned in the article. He attended our December 2008 support group meeting in San Mateo, CA. He told many stories about caring for his wife with LBD.

Robin



The New Face of Caregiving: Male Caregivers 
By: Cathie Gandel 
Source: AARP Bulletin Today 
January 23, 2009 

When his wife, Chris, was diagnosed with breast cancer on their 19th wedding anniversary, Dave Balch suddenly found himself with two full-time jobs: running his home-based software business and taking care of her. “I don’t know how I managed everything,” says the 60-year-old from Twin Peaks, Calif., whose wife continues to fight recurrences of the disease six years later. “But you do what you have to do.” 

Each year, more Americans are finding themselves in a similar situation—and challenging preconceived ideas about men and caregiving. 

“People think that male caregiving means that the guy calls home from the job and asks his wife how his mom is doing,” says Donna Wagner, professor of gerontology at Towson University in Towson, Md. “That’s not true at all.” 

A 1997 survey conducted by AARP and the National Alliance for Caregiving, a research and advocacy coalition, found that 27 percent of caregivers were men. By the 2004 update, that figure was almost 40 percent, with more male caregivers (60 percent) working full time than women caregivers (41 percent). Among the reasons for the increase: smaller families, longer life spans, more women working outside the home and greater geographic separation of family members. 
While male caretakers face many of the same challenges as their female counterparts—including depression, stress, exhaustion and reduced personal time—they approach their caretaking role differently, say some experts. 

“Men approach caregiving as a form of work, a series of tasks that needs to be accomplished,” says Edward H. Thompson, coeditor of Men as Caregivers and director of gerontology studies at Holy Cross College in Worcester, Mass. “I don’t mean that to sound harsh. It’s just the way they look at things.” 

Because they are used to delegating, they are more comfortable seeking outside help when they need it, says Richard Russell, associate professor of social work at the State University of New York’s College at Brockport. 

Donald Vaughan, a 51-year-old freelance writer in Raleigh, N.C., has an aide come in three times a week to bathe and shave his father. “It’s worth every penny I pay,” he says. 

But despite feeling isolated, men tend not to seek help for themselves, at least not from traditional support groups. Instead, some forge their own connections. In Rochester, N.Y., some fellow caregivers meet once a week for breakfast. “The men talk about sports, politics and grandchildren,” Russell says. “They don’t mention caregiving. It’s as if they have made a pact that this is their time to be just regular guys.” 

Men also try not to bring their caregiving situation into the workplace. They not only have been socialized to keep things close to the vest, they also perceive a stigma associated with taking time off for caregiving responsibilities—and sometimes a lack of understanding from employers. 

John Young experienced that feeling firsthand. The 55-year-old nursed his late wife through Lewy body dementia, a disease that combines the mental deterioration of Alzheimer’s disease with the physical disability of Parkinson’s disease. When his wife became ill, Young was teaching in a police academy in a Houston suburb. At first she was able to stay on her own while he worked, but one day she called with an emergency and he had to rush home. “When I returned, my boss called me in and asked, ‘How much longer does she have?’?” Young says. “I knew it was time to go.” 

Even those who work at home have trouble juggling responsibilities. “Taking care of my dad has had such a dramatic impact on my life,” Vaughan says. “One part of my brain is always on my father. And my time is nickel-and-dimed throughout the day. It’s hard to get a long period when I can do my work.” He interrupts his writing intermittently to make sure his father drinks enough fluids and walks up and down the hallway for exercise. 

“The worst part is the exhaustion,” says Gary Noble, 64, who cares for his wife, who has multiple sclerosis. He also works as a bus driver in Livermore, Calif., and often has split shifts. He may come home at 8:30 p.m. Before he goes to bed at 9:30, he has to cook, clean up and tend to his wife’s needs. He needs to be up again at 3 a.m. “I’d appreciate just a few hours off sometimes,” he says. 

John Carlson, 57, of Woodbury, Minn., takes care of his 88-year-old father, who is in the early stages of Parkinson’s. “The most difficult part is having time away from home,” he says. “Dad covets my time, as most of his days are spent alone.” 
While any relationship may suffer in the caregiving equation, the issues are particularly difficult for those caring for a spouse, says Donna Wagner. Richard Anderson, president of the Well Spouse Association, a nonprofit organization that provides peer support to those caring for a partner with chronic illness or disability, agrees. He took care of his late wife, who had an autoimmune disease, for 29 of their 31 years of marriage. 

“Spousal caregivers are different because of the intimacy of the relationship,” he says. “It’s hard to have sexual feelings toward your partner if you have to deal with incontinence and other personal issues.” 

Despite the difficulties these men face, there is some good news. “My wife and I spend a lot more time together,” says Ray Heron, 57, of Charlottesville, Va., who has been caring for his wife, who has MS, for 10 years. 

The caregiving relationship has brought Chris and Dave Balch closer, too. “This can really put your love for each other to the test,” Chris says. “In our case, it made it stronger.” 

Tips for Male Caregivers 

“There is no manual on this,” says Vaughan, the freelance writer in Raleigh, N.C., who cares for his father. “You learn day by day.” But here are seven tips passed on by men on the front lines of caregiving. 

1. If someone asks what they can do to help, have a list in the back of your mind and tell that person. 

2. Have something to look forward to—whether it’s a big trip or just a rental movie to watch at home. Remind yourself that you will get through this. 

3. Acknowledge your emotions. You’re human, not a robot. 

4. Set up a group e-mail to keep family and friends in the loop. 

5. If you’re a spousal caregiver, don’t put off shared pleasures. If you and your wife always dreamed of going to the Caribbean and the trip is still feasible, do it now. 

6. Remember that most of the little issues don’t count. Discuss them and find what works for both you and your patient. 

7. Learn as much as you can about your patient’s disease, even though it might be scary. 

——————————————————————————– 
Cathie Gandel is a freelance writer based in New York.

Advocate for NIH Funding

This email about NIH funding may be of interest here. I received it earlier today from the Association for Frontotemporal Dementias. (CBD is a subtype of FTD, and PSP is considered a related disorder.)

Date: Mon, 2 Feb 2009 20:44:56 +0000 (GMT)
From: <[email protected]>
To: Robin Riddle
Subject: Advocate for NIH Funding

Dear AFTD Community:

Here is a quick and easy way to contact your local Senators to support science investment in the Economic Recovery Package!

Senator Arlen Specter (R-PA) is prepared to offer an amendment on the Senate floor as early as today, Monday, February 2, 2009 to provide $10 billion for the National Institutes of Health (NIH) in the economic recovery package. Please take five minutes to ask your senator to support this crucial amendment today.

This amendment would provide funding for grants that could be distributed by NIH right away. NIH funding is fundamental in promoting research to improve the diagnosis, treatment and quality of life for people suffering from neurological and psychological disorders, including Frontotemporal Dementias. Attaching this amendment to the Economic Recovery Project highlights the importance of science funding for its potential to create jobs and stimulate state and local economic growth.

Our colleagues at the American Brain Coalition are urging all of us to join them in voicing our support for expanding research funding at the NIH. Please follow this link and with a few clicks of the mouse, you can send letters to your Members of Congress. Please visit http://capwiz.com/americanbraincoalition/home/. There will be a ‘Take Action Now’ box. Simply click on “Contact Senators to Support Science Investment in Economic Recovery Package” and follow the steps. The suggested text is fully editable and we encouraged you to personalize your message.

As a community, we can effect change and make sure that FTD gets the awareness and funding it deserves!

Thank you for your immediate attention to this initiative.

Sincerely,

Louise O’Conner and Bill Brown
Co-Chairs
AFTD Advocacy Committee

Argyrophilic grain disease – Mayo brain bank description (2002)

This is research published several years ago from the Mayo Clinic Jacksonville Brain Bank.  I’ve been noticing some neuropathology reports that mention argyrophilic grain disease (AgD).  Usually this is in combination with progressive supranuclear palsy (PSP).  There are no diagnostic criteria for AgD for when someone is alive.  It may be associated with mild cognitive impairment but it seems we aren’t very sure!

The abstract is copied below.

Robin
———————————

Brain Pathology. 2002 Jan;12(1):45-52.

Argyrophilic grain disease: neuropathology, frequency in a dementia brain bank and lack of relationship with apolipoprotein E.

Togo T, Cookson N, Dickson DW.

Abstract
Argyrophilic grain disease (AGD) is a recently recognized disorder whose relationship to dementia as well as genetic or biochemical features remain incompletely characterized in part due to diagnostic difficulties engendered by concomitant pathologies. In the present study, we reviewed a consecutive series of over 300 brains referred for evaluation of dementia for presence of argyrophilic grains (AGs). AGs were found in the hippocampal region and amygdala, and were accompanied by coiled bodies in the underlying white matter and ballooned neurons in the limbic lobe. Ballooned neurons were also found in the limbic lobe in a number of cases of advanced Alzheimer’s disease (AD) that did not have AGs, supporting the lack of diagnostic significance of ballooned neurons confined to limbic lobe. The frequency of AGD in this series of dementia brains was 4.9% and was similar to the frequency in other autopsy series of nondemented cases, supporting the notion that there is no obligatory relationship between AGD and dementia. In the present series, ApoE epsilon4 allele frequency of AGD was dependent on concurrent AD, with AGD cases lacking AD similar to controls and cases with concurrent AD similar to AD. This suggests that AGD is an independent disease process from AD.

PubMed ID#: 11770901  (see pubmed.gov for the abstract only)

“Learning to Be Good Enough” as a caregiver (NYT)

I really enjoy “The New Old Age” blog on the New York Times (nytimes.com). Last Thursday’s entry was about the concept of NOT being a perfect caregiver but being a good caregiver. This is one of the best articles on caregiving I’ve ever read.

The blogger says: “There is an old saying about not letting the perfect drive out the good, a notion that I think is essential to providing sensible and loving care to an aging parent and maintaining one’s sanity during the process.”
Here’s a link to the New York Times blog post:
http://newoldage.blogs.nytimes.com/2009/01/22/th-good-enough-daughter/

Learning to Be Good Enough
By Jane Gross
January 22, 2009, 12:16 pm
New York Times

The New York Times post refers to a blog titled “A Good Enough Daughter” by Sara Myers. Here’s a link to that post:

“A Good Enough Daughter” blog
by Sara Myers

http://www.silverplanet.com/blog/good-enough-daughter

You can read a slightly different version of this explanation by Sara Myers here:

“I Can’t Make Everything OK”
By Sara Myers

http://www.silverplanet.com/blog/good-enough-daughter/i-can-t-make-everything-okay/5611

All of these are worth checking out!

Getting Support – Go through your list of friends, etc.

Although this advice for caregivers was written by someone whose husband has Alzheimer’s Disease, I think her advice on going through your list of friends (and identifying who can do something, who can listen, and who prefers to continue on as if nothing has happened) is a useful approach for all caregivers. This is perhaps a good exercise for those diagnosed with a neurodegenerative disorder too.

Robin


http://www.thealzheimerspouse.com/CaregivertipsHowe.htm

Alzheimer’s Association
SUGGESTIONS FROM A CAREGIVER – Support, Part 1
By Elizabeth (Betsy) Howe, M.B.A

Dealing with dementia in a loved one can be overwhelming at times, or most of the time. Not only do we have our own lives to conduct, we are trying to do the best we can for our loved one. All the time we are also grieving the loss we both are undergoing. You about get used to one level of effort and things change and get harder.

As caregivers we are advised to reduce stress, keep a life of our own not involved with caregiving, exercise, and eat properly. The focus of this article is reducing stress. The caregiver’s key to reducing stress and keeping THEIR sanity is …. support support support …and the most important…SUPPORT.

Many articles tell us that if we don’t take care of ourselves we can, and do, become statistics ourselves. We die earlier than our non-caregiving peers, or worse yet, before the loved one we are caring for.

One of the useful things I’ve been advised to do is make a list of all my friends, family and acquaintances. Next to each name I indicate what role they can play in reducing my stress level through support in three categories:

1. ‘D’ goes next to the names of those who can be counted on to ‘Do’. There are and will be things we inevitably will need done or need help doing or leaning to do ourselves.

2. ‘L’ goes next to the names of those who can be counted on to ‘Listen.’ We need people we can talk to, even if we end up saying the same things over and over. I suggest, if possible, you find one or two you can literally call 24/7.

3. ‘C’ goes next to the names of those who prefer to ‘Continue on’ as if nothing has happened. They prefer not to talk or hear about the nasty things going on in our lives and the life of our loved one. BUT they are willing to continue to be our friend. These people are essential for those times when we just want to ‘get away’ and pretend to be like everyone else (non-caregivers).

Think about those you know in all avenues of your life – work, professional associations, family, friends, church. Be sure to include all people you know. You might be surprised at the number of potential support people you have. Don’t forget to think about those who know/ knew your loved one. Often they will be happy to support your loved one by supporting you.

Keep your list in a notebook or on your computer or electronic planner so it’s easy to find and add to. If you are extremely lucky you will have one or two people who are all three- D, Land C! Just try not to ‘bum out’ any one person. If they can support you in more than one category, it’s easy to do. You are in this for the long haul and need ‘D’, ‘L’ and ‘C’ support long term.

I am finding that those of us actively involved in caregiving truly CARE for each other as well as our loved one. Sometimes helping someone else is a stress relief for me! Be open to new friendships with those you meet through various support groups, such as the Lincoln Alzheimer Association Young Onset Support Group that meets twice a month and has activities periodically.

Don’t forget the Alzheimer’s Association 24/7 Helpline, 1-800-272-3900, or [email protected] as someone to ‘Listen’ but also provide helpful suggestions. I prefer the phone if I have immediate issues involving my loved one and want to know how to handle something that’s going on right now. They have trained personnel with whom you can speak.

Even if you have a great local counselor or psychologist with whom you are working, the local professionals aren’t generally available 24/7. If you are looking for something that is not so immediate, the email address is a good bet.