Muscat: Dementia is a chronic disorder characterised by severe memory loss and forgetfulness and the sufferer’s condition deteriorates with time.
The patient will eventually require support for the basic activities including bathing and feeding. The caregiver is a relative and family member who has to assist the patient in his daily activities.
The task of care giving is possibly one of the most difficult as it exposes the caregivers to various emotional and physical challenges such as seeing a loved one lose their mental capacity with forgetfulness even of the family members.
In Oman we have encountered many people suffering with anxiety and depression because of the task of caregiving and the demands of looking after a loved one.
An example is a paediatrician who stopped her career after she found herself the only caregiver for her mother with Alzheimer’s dementia. Her time was devoted to her sick mother who eventually became fully dependent on her daughter to look after her.
Caregivers in Oman are not different from the rest of the world in terms of suffering and crying for help.
A recent study done by my colleagues and I at the Sultan Qaboos University Hospital (SQUH) found that two thirds of caregivers are experiencing a high degree of stress due to the burden of caring for a loved one with dementia. This can expose the caregivers to depression, anxiety and sleep
disturbance. My colleague, Dr Hamed Al Sinawi, has studied the feeling of guilt among caregivers and found that more than half of them are preoccupied with guilt and thoughts that they aren’t doing enough for their loved ones.
This sense of guilt in the caregiver can lead to self-blame and also depression.
The support available to the caregivers is currently very limited. There are only a few people specialised in old age health care and the service is not widely available throughout the country, however initiatives such as the family doctor awareness programmes and dementia care groups designed to help the elderly and their caregivers are developing.
In addition to these programmes, I suggest initiation of a home based community service to provide an outreach service to the elderly, many of whom are too infirm or confused to come to hospitals or health centres. This will solve many problems encountered by patients and their caregivers including transportation and medications administration.
It will also yield a better assessment of the psycho-social situation and lead to even better care and health for our elderly citizens.
In conclusion, the caregivers of patients with dementia are performing a highly demanding and stressful task. They are at risk of depression, anxiety and burnout. As a society we should be aware of the great, often unseen role played by these caregivers and provide support to them when required.
Last year, the Times of Oman launched a campaign to help boost palliative care services in the country which received a huge response. This article, written by Dr Mundher Al Maqbali, Senior Resident in Psychiatry at the Ministry of Health (MoH), is the first part of a three-part series on palliative care.
Maggie Jeans, a long time British expat in Oman who was a caregiver to her husband, has been a major campaigner for palliative care. She said, “We are very pleased to see that things are moving in the right direction and that the ministry is very keen to take this forward.”