Taking care of family members with dementia is a long journey. Caregivers could become so physically and mentally exhausted that they overlook their own well-being. Only if caregivers manage well their own stress as well as stay physically and mentally healthy, can they take proper care of their family members with such disease.

The following 2 points may bring some comfort to these families:

1. "A blessing out of misfortune" –Fortunately, the disease would not pose immediate death risk, nor cause physical discomfort.
2. "Being carefree is a blessing" – A patient with dementia may turn into a different person who does not share worry or happiness with his/her families anymore. This may bring about a sense of loss to caregivers. Nevertheless, patients may forget the troubles and worries of life, and do not have fear for illness or death. They can be as simple and naïve as they can be. Aren't these consolable to the caregivers?

In spite of paying tremendous efforts in care giving, family caregivers can still maintain an active and vigorous mindset amidst the challenges of care giving -

Leading a life of virtue in care giving

Family caregivers, such as spouses and children can practice the following virtues throughout the care giving process:-

• Patience and perseverance – to cope with setback and adversity.
• Insight and analytic ability – to probe into problems, to become curious learners and problem-solvers. The process can be satisfying.
• Versatility and creativity – Let's not stick to the conventional ways; learn to apply useful knowledge, optimize the use of resources and adopt creative strategies in problem-solving.
• Testimony of true love – Spouses of persons with dementia can fulfill their love promise of "till-death-we-part" through unfailing companionship and care giving.
• Filial piety and responsibility – By devoting to the care giving, the younger generation return their love to parents, leaving no regret in the future.
• ratitude and humour – Despite the labour and stress of care giving, treating the naïve and innocent patients with a sense of humuor can help make fun moments out of agony.
• Introspection – Many caregivers who have taken care of family members with serious illness or chronic diseases tend to pay more attention to health maintenance as a result. In retrospect, they derive life meaning, readjust life values and yearn more for spiritual satisfaction.

The rewards of care giving to family members with dementia can be summarized in three dimensions:

• Personal growth – knowledge gain, strengthening of self-reflection ability and adversity-coping ability.
• Emotion bonding –greater affection for the sickened family member, more interactions within the family.
• Deepened insight about the meaning of life and spiritual faith.

Family care givers should pay attention to dimensions related to mental well-being, such as malaise, emotional instability, relational conflicts or distance etc. They can use the following methods to manage their stress and should seek professional advice if needed.

Tips for family caregivers in stress management:

Caring patient ─

• Monitor the patient's condition closely and set realistic expectations. For example, to decide whether the patient needed help or could do things by themselves only after assessing his/her illness severity and capabilities.
• Avoid arguing with the patients. Avoid blaming them for things that are beyond their capability or comprehension. Look for solutions instead of trying to prove that "I am right, you are wrong."
• Maintain positive feelings and relationship with each other. Being calm oneself is helpful in calming the patients. This also helps to solicit trust and cooperation from the patient.
• Simplify the caring process and develop routine practice.
• Share your workload with other family members. Be willing to share skills and experiences. Be supportive to one another.

Self-care ─

• Take care of your own well-being. Ensure to have enough sleep, regular exercise and a balanced diet.
• Maintain social life and keep contact with your friends. Chatting with friends is relaxing and may provide insights towards problem-solving.
• Relaxation skills, such as deep breathing and muscular relaxation can keep you calm.
• Seek appropriate social resources, such as support groups for the family caregivers for mutual support, consult health care professionals for knowledge and information and utilise day care programmes and respite care services for sparing some personal time and space to relieve the burden of care.
• Give yourself positive feedback and self-assurance for your contribution to the caregiving.
• Avoid maladaptive ways to manage stress, such as denial or avoidance, substance or alcohol dependence etc.
• Stay positive and remain hopeful about the future.

Get prepared for the patients' dying: ─

• Families may plan ahead (or with the patients in early stage of the disease), for financial arrangement, living arrangement, and other life care decisions in advance stage of the disease and for natural death of the patients.
• When the time comes, families may need to pass the care duty to professionals of residential care services or hospitals. Families can visit and may take up the evaluation or supervision role.
• Without the need of daily care- giving to the patients, families can readjust to their new and quality life pattern.

Support Service for Caregivers of the Elderly:

Organization	Tel. & Web Page	Support Service for Elderly Care
Elderly Health Service, Department of Health	2121 8080 Elderly Health Service web page	24 hours hotline on health information
Social Welfare Department	2343 2255 Social Welfare Department – (Elderly) Carer Support Service	Various kinds of supportive services

Related Audiovisual and Booklet Package(s):

Practical Tips for Carers - Dementia Care
Practical Tips on the Carers of Elders with Moderate to Severe Dementia - Dementia Care II