Be­hind ev­ery pa­tient

Orlando Sentinel - - FRONT PAGE - Beth Kassab Sentinel Colum­nist

is a care­giver, and their health should be a pri­or­ity, Beth Kassab writes.

Pa­tients in Dr. Rose­mary Laird’s Win­ter Park of­fice rarely walk in alone.

A board-cer­ti­fied geri­a­tri­cian with a fo­cus on Alzheimer’s disease and me­mory loss, Laird is ac­cus­tomed to find­ing two peo­ple in each exam room — the pa­tient and a care­giver.

“We call it two pa­tients,” she said. “For ev­ery one older adult we take care of, there’s usu­ally some­body else in the pic­ture.”

That’s healthy for the pa­tient. A spouse, an adult child or some­one else to help with ap­point­ments and home care is of­ten es­sen­tial.

But what about the health of the care­giver?

That’s a need Laird would like to see ad­dressed more of­ten.

“I’ve been prac­tic­ing in Florida for about 25 years,” she said. “It’s a sad re­al­ity. In my ob­ser­va­tion, what care­givers strug­gle with now, it’s very sim­i­lar to 25 years ago.”

There are more gen­eral re­sources for care­givers to­day. Es­pe­cially on­line.

But when it comes to help­ing a care­giver nav­i­gate the com­plex­i­ties of an in­di­vid­ual’s care, spe­cific help is of­ten lack­ing.

Take the hus­band who re­cently came into her of­fice with his wife, who has Alzheimer’s. She re­cently be­gan re­fus­ing to take a shower.

The hus­band wanted to know: What do I do?

“How can we help him give her a shower in this new nor­mal they are liv­ing in?” Laird said.

She worked through that with the hus­band. And there isn’t nec­es­sar­ily a Medi­care box to check to de­scribe that’s what they did dur­ing the ap­point­ment.

“But it’s a nec­es­sary part of her care,” she said.

And it’s more im­por­tant than out­side ob­servers might ex­pect for the care­giver as well.

Laird, who co-wrote “Take Your Oxy­gen First: Pro­tect­ing Your Health and Hap­pi­ness While Car­ing for a Loved One with Me­mory Loss,” says chronic stress ex­pe­ri­enced by care­givers when prob­lems such as the shower predica­ment — or even more se­ri­ous con­cerns — pile up is detri­men­tal.

“The hor­mones as­so­ci­ated with chronic stress are very neg­a­tive,” she said. “It’s al­most like an ac­cel­er­a­tion of ag­ing.”

Many care­givers know they need to watch their emo­tional stress by tak­ing some time away or mak­ing a point to have other ac­tiv­i­ties in their life that they en­joy.

But Laird of­ten sees care­givers who haven’t been to their pri­mary care doc­tor or even a den­tist in years.

“The most im­por­tant thing we try to con­vince our care­givers of is to kind of take stock of their phys­i­cal and emo­tional health,” she said. “If they find things that aren’t as strong, try to use this mo­ment of learn­ing about how stress can im­pact them as a care­giver to plan for some changes.”

She ad­vises that care­givers not to try to fix ev­ery prob­lem at once. Pick one thing a month to tackle. Maybe sched­ule a pri­mary care

ap­point­ment for your­self. Or be­gin tak­ing walks around the neigh­bor­hood a few times a week. Or ask for more help.

Eas­ier said than done, right? But, prac­ti­cally speak­ing, some care­givers might have no idea where to turn for that kind of help.

This is where care­givers can use good old-fash­ioned con­sumer power.

Laird’s prac­tice, which is part of the Florida Hos­pi­tal sys­tem, of­fers the ser­vices of a nurse prac­ti­tioner and a so­cial worker to work with pa­tients and their fam­i­lies on every­thing from lo­gis­ti­cal prob­lems such as trans­porta­tion to men­tal health.

“Con­sumers have more power than I think they re­al­ize in the health care set­ting,” she said. “I think if more of them start ask­ing for that kind of sup­port, then it tells us as a health care sys­tem that’s the kind of pro­gram and ser­vices we need to be pro­vid­ing.”

That kind of com­pre­hen­sive ap­proach can lead to the care­giver hav­ing more con­fi­dence in the care team and, ul­ti­mately, in them­selves when it comes to find­ing an­swers and help­ing to make decisions.

“Care­givers tell me their stress is less­ened when they know they have a med­i­cal team they can ac­cess and rely on to help them fig­ure out what to do next,” Laird said.

Care­givers who don’t feel that way can and should de­mand more from the providers they are see­ing — and be will­ing to go else­where if their needs aren’t met.

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