Q&A: How can psychologists help?

Recently, I was contacted by a Danish journalist through my blog here. At first, I was super excited that a journalist was quoting me and wanted some further information! I mean, that’s great news and a great feeling 🙂

Then, I realized that she was quoting someone else and I’m not exactly sure why she thought it was me….

So, I wrote her with the real author’s name and with a response that I hope will be useful for her in her article. Her mail and my response are below – I have translated them into English.

I’m researching an article for Psychological Association’s magazine on psychologists in nursing homes and encountered a publication ‘Older, relatives and caregivers – inspiration for cooperation’ where you write:

There is a need for specialists (geropsychologists, dementia consultants, dementia teams, or others with special training in the elderly) who can advise on conflict resolution and, for example, guidance on handling difficult behaviors of people with dementia as well as on cooperation with relatives. It is problematic that carers who must carry out some extremely complicated tasks are not regularly included in the training courses or offered supervision for personal development and qualification.

I’d love to hear you if you can elaborate on what it is that psychologists can do in the above context and how they can use their professionalism for people with dementia? I hope that you have the time and opportunity to contact me.

And I answered,

Thank you for your message, but I think there is a misunderstanding. It is Ingrid Lauridsen who has written what you cite in your email. But, I think I can still give some answers to your questions.

One concrete way that psychologists can help in conflict resolution is through mediation and interpersonal counseling. When a family member, particularly a parent, has dementia, it is not uncommon that the children and their spouses will disagree on the level of impairment, how and where care should be carried out, what is in the best interest of their parent, and many issues around handling the finances, property, and other valuables of the parent. These conflicts can create tensions both within individuals and between family members which can be particularly difficult to resolve because so many past emotions are tied into the current situation. Children may be dealing with emotional trauma of a strained relationship with the parent or an unhappy childhood as well as strained relationships with siblings, guilt over care for their parent, and resentment if one feels they are providing more physical, emotional, and financial support for the parent.
Another way that psychologists can help is in help the families to understand that dementia is due to the brain changing, which can also cause emotional, personality, and behavior changes. It is not uncommon that families will think that the person with dementia is purposely being mean or difficult, mostly because they don’t understand that dementia can cause a wide variety of symptoms. In particular, the behavioral and psychological symptoms of dementia (called BPSD) are some of the most stressful aspects of dementia care and are correlated with higher rates of carer depression and burden. Some of the most difficult symptoms can include acting inappropriately in public, acting out sexually, violence, refusing care such as bathing, toileting, and eating, and sleep disturbances which cause the carer to be awake all hours during the night.
In the quotation you gave in your email, one issue is to address education and training for the family carers on what dementia is, what some of the BPSD can be, and how to manage them as best as they can – including taking time to care for themselves to avoid further physical and psychological strain from their role as a carer. Another issue is how psychologists can help in their professional roles, which can include education and training on how to alleviate stress, how to deal with feelings of guilt and loss, that it is encouraged to seek out professional help and that doesn’t make someone a bad carer or love the person with dementia less, and how to address and manage the feelings that carers often face.
The document she was quoting in her mail is in Danish, called Ældre, pårørende & plejepersonale – inspiration til samarbejde. If you are interested in reading it, click here to access the Ældreforum page and download the pdf file.
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