Caregiving takes an enormous emotional and physical toll even when it is a labor of love and/or obligation. In the case of caring for someone with progressive memory loss, a spouse or child often has to parent their partner or parent. This sets up a natural and sad antagonism. The caregiver must set limits and enforce rules (nag and be bossy) and the care receiver isn’t aware that they need the guidance as they forget that they forget and resent and resist rather than appreciate the efforts on their behalf.

Take for example the case of a caregiver (partner or child) who is caring for her very forgetful but very bright husband/father. He is so forgetful that he cannot monitor how much money he spends in any given month and is prone to overspend. His partner/daughter has to put him on a budget (remove credit cards and take over the finances) so he has money to continue to live in his home. He is understandably angry and resentful. She is sad, anxious, hurt, and guilty. Furthermore, he forgets to take his medications despite an organized pill box and this must be managed by others. Finally, there is the issue of whether he is still safe to drive and needs a driving evaluation. He is irate, she is tearful and overwhelmed. Once all of these issues are resolved and he gets over his anger and used to the new structure, things will settle down – in time.

These conflicts take their toll on both caregiver and care receiver and create many gut wrenching dilemmas. Treatment must be sensitive to both parties. We often neglect caregivers in the formula as they may be prone to refuse assistance as they don’t want to burden others. The most effective caregiving is accomplished by balancing the needs of the one you love and your own needs. Treatment is simple to state but difficult to implement. Try some of these strategies but remember nothing works every time.

• With severe short-term memory loss you cannot say something often enough for it to sink in. You must do what needs to be done without expecting understanding or gratitude. Keep discussions short – no longer than 15 minutes – and try to not take the anger personally.
• Pick your battles. If the issue is not critical don’t go toe to toe.
• Get assistance in working through issues by talking to an experienced memory expert or support group. They don’t have all the answers but may help you plan strategies and provide support in difficult situations.
• Expect your agreements to be forgotten and give time for the anger to settle.
• Go for a walk. Short walks can be very restorative and help you to settle down.
• Do something you like such as going to a movie, concert, shopping, out to lunch with a friend. You need to defuse your stress if you are a caregiver.
• You will have some bad times/days no matter what you do. Caregiving and receiving is hard.
• Get a pet. They are great listeners.
• Exercise daily for at least 30 minutes.