I was browsing through the Canadian Family Physician Magazine (Vol 64 April 2018) and the ‘Geriatric Gem’ caught my interest. The topic is on supporting caregivers, specifically those of persons with dementia. The evidence presented is that “caregivers of persons living with dementia are at higher risk of depression, substance abuse, and exacerbation of underlying illnesses.” Furthermore, “improving caregiver well-being can help keep persons with dementia living in the community rather than being placed in long-term care.” No surprise here. The challenge is ensuring family docs are paying [enough] attention to the family caregiver. If the person with dementia and the caregiver have different family doctors, then I wonder how open the caregiver is to sharing some of the daily challenges without being asked about it. I understand there is a shortage of family doctors in most provinces so it is hard to say how much ongoing and regular follow up there is for many of these caregiving families. The SMILE tips were provided by a family caregiver and an abbreviated version is highlighted below:

Stages of Life: Just as our parents accept us at every stage of our life as we grow up, accept the person with dementia at every stage of their illness. It is better to enjoy and love them as they are now than to get stuck on how they used to be.

Moments: Whenever possible, caregivers should look for and try to create precious moments.

Interconnect: Although friends might fall away and family might not always understand, it is important to never isolate oneself. The caregiver is not just the caregiver but is also a care coordinator, connecting and inviting others to participate in the patient’s care.

Laugh out loud: A smile and a laugh can help with responsive behaviour and can be contagious. Finding things that make the person with dementia laugh can help with difficult situation and is good for everyone!

Experiment: What works one day might not work the next; the caregiver will need to experiment. Experiments should not feel like failure- if something does not work it can still stimulate creativity and collaboration, especially as the person’s illness progresses.
Remember- caregiving is dyad and it takes two people and both have to have their needs met.