attention deficit and communication hurts everyone, especially the elderly.

3 days ago, our neighbor twice called an ambulance: a hypertensive crisis. The reason is quite understandable: chronic sores, multiplied by loneliness, experience, and communication.

She is 80. She moved into our house 3 months ago. Lives alone. She did not want to go live with her son or daughter.

Okay, first floor. The elevator is nearby, so all the residents of the entrance pass several times a day near her door.

All my life I lived in my house: good, solid, with a large plot, more than 20 acres. I sold everything, because I no longer have the strength to take care of the garden and the garden. And being alone, especially in winter, is not easy. No, no, interruptions sometimes happen with heating, sometimes with water.

All life in labors and worries. I'm not used to shifting work to someone, and even more so - taking care of myself. She raised three children. I gave everything I could and even more, without thinking about myself.

One daughter was buried 20 years ago. There are 2 granddaughters left: 9 and 12 years old. Grandmother helped as much as she could. Life forced them to survive and work. Both are firmly on their feet. Granny is helped financially. They helped with the move, quietly equip the apartment.

The second daughter was admitted to the hospital a week ago: seriously and probably for a long time. The third granddaughter has enough worries about her mother. Moreover, they say: one trouble does not go. I went to my mother in the hospital and right in the hospital yard a snow block fell on the girl.

These two news completely knocked down our neighbor.

Her son also lives in our city. Not poor. Offended by his mother. Didn't listen to his move. She did it her way. On forgiveness Sunday, the mother decided to call her son herself. On such a day, all people, and relatives - even more so - ask each other for forgiveness ... The son did not pick up the phone. Pride ... What kind of communication and attention can we talk about here?

And the mother continues to pray for everyone: for the dead and especially for living relatives.

And deprived of attention. I would even say this: she suffers and gets sick due to a lack of attention and communication.

Simple human interaction is not enough. Days passed after the arrival of the ambulance. Grandmother timidly dials her granddaughter's phone number, and in response, silence. And the woman, embarrassed, justifies her granddaughter. Like, he works all week, and today is Saturday: he sleeps off.

I understand my neighbor, her wisdom and modesty. But I can not accept the position of a granddaughter. If you know that a dear little man lives nearby, in your city, your granny, and even weaker: only 1.5 months ago she had an operation at such a respectable age, if you can not come once again - CALL HER! At least do not put it on silent mode, so that in which case, an ambulance can be called or supported with a kind word.

After all, vision is not the same. She is wearing glasses, and there is a large magnifying glass nearby. It's not for fun.

The next day, leaving the grandmother, I meet her girlfriend, from the 2nd floor. She is 83. Also the same problem: she lacks communication. The grandson, who had lived with his grandmother for many years, offered her, after marriage, to sell the apartment and live together, already in a three-room apartment with an improved layout.

It is clear: the business is young, it looks to the future. A month ago I found a more promising job and went to Moscow for six months. His grandmother is still nothing, strong, independent. She came up to me today and asked me to come in. Why do you think? He treats me with homemade jam and compote. Complains that no one has it.

And I understand: she just wants to talk. It turns out that my grandson is 30 years old today. She wanted to call, congratulate. And his phone is not answered. Turns out he has a different number. Granny called for the last time on March 8th.

Why is that? Where does such callousness come from? After all, both grandmothers are sensible, very modest; superfluous not that they will not ask - they will not even ask.

Even if you're worried about being interrupted on the office phone, give the grandmothers a different phone number, insert another card so you know it's for the grandmother. Like SOS. Is there anything that could happen? The door slammed shut, it became sharply ill: the medicine was needed, the snowstorm was outside, it was impossible to go out for milk and bread. And they don't ask for this. Strangers live nearby or one of your friends or relatives will visit.

They lack communication and your, dear, attention.. Give them just 3 minutes of your precious time. Ask: “How are you? Everything is fine? I have, as always: emergency, blockage, spinning, spinning, working. I love. Kiss. I'll call you in the evening."

All! That's enough for them! She will have enough of your words, your emotional pill - and she is better than any medicine - until the evening. And then call again: “Grandma, I’m at home. I'm fine. How do you? Don't worry. Have you eaten? How do you feel? Everything is fine? Hug you. Goodnight. I'll call tomorrow."

And these words will make her breathe a sigh of relief. She will shine with an inner smile. He will definitely pray for you both in the evening prayer and in the morning. Your call is a thin thread that keeps her in this life.

It means they are worried about her. She is appreciated and loved. She is cared for and remembered. Children and grandchildren are the meaning of her life. She wants to wait for her great-grandchildren!

And tomorrow, meeting with a neighbor, she will be calm and joyful. She will proudly talk about the fact that her grandson or granddaughter has such a serious job. She will remember how you grew up, studied. She remembers everything, every little thing. Because it's the little things that make up our lives.

And the older a person becomes, the more conversations turn into memories.

And if our parents, our grandparents now live alone, all the more so if they found themselves in a different environment, if before that they had lived all their lives among acquaintances who became so close and dear to them and then suddenly suddenly lost contact with them - they resemble small children. children whom their mother took to kindergarten and does not pick up for a long, long time.

Think back to your childhood. What did you experience while doing this? Did you feel like crying? You complained to your mother: please do not stay late at work. Pick me up, please, early tomorrow, or better right after dinner...

Our mothers, our grandmothers do not complain. They are silently sad and furtively crying. They are looking for an excuse for your indifference, referring to your busyness and the vanity of your current life.

But they never go to bed without praying for everyone. Especially for you, the grandchildren, their soul hurts.

• And your soul hurts for your old people?
• Do you remember when their birthday is?
• Are you not worried that today you did not hear their voices, did not ask about how you feel?
• When was the last time you spoke to them just like that?

But there comes a period in the life of every person when everything is no longer so simple.

• It's not easy to climb stairs.
• It is not easy to fall asleep in the evening when you are alone within four walls.
• It is not easy to endure a long separation.
• It is not easy to hide pain for a long time, especially mental.

Therefore, when you see such elderly people, you can determine from the first minutes of communication: they are treated kindly with attention or vice versa - they are deprived.

In fact, we deprive ourselves of attention, we! Because they have so much wisdom. Yes, you can write them down. Whatever the phrase is valuable advice: how to protect your health, and how to get along with your husband or children. They are laconic. On the contrary: they say little, but there are many valuable thoughts in what they said.

Every word they say is thought out, weighed, verified by long life experience.

Yesterday, the daughter ran to get medicine for her grandmother. The district doctor prescribed her an ordinary motherwort. She hugged and kissed Galochka. It turns out that yesterday was the day of St. Galina. So they are birthdays! Why not a reason for happiness, for hugs?

For 10 minutes of communication, so many interesting and, most importantly, useful, grandmother told Galochka. She listened and asked: “How do you know all this?” And we unanimously: "From life." And they laughed.

And then Galina Mikhailovna says: “And sometimes I also communicate with the TV.” It was the phrase of the day! She is really very selective about watching TV. Communicate with him! That's how! Isn't this science for our generation?

Once everything: both you and I will move into a period of respectable age. What will it be like: dreary and lonely, like my new acquaintances, or filled with communication, mutual care and attention?

No wonder they say: our children do not what we teach them, but what we do ourselves. We are happy in our own way. We have two grandmothers. They live side by side, in the same building. And both are wonderful. God bless them.

Today I treated both of them with a salad. They say to me: "Kingdom of heaven to your mother." I almost burst into tears. Lord, how little a person needs for understanding and happiness. A good word spoken at the right time. It's so simple: support the person who lives nearby.

P.S. Volodya says to Galochka: “Our mother works as a psychologist for grandmothers.” I agree. What is the main role of a psychologist? Listen to the person, support and help with a kind word.

P.P.S. My daughter came from the cinema and, seeing me sitting at the computer, asked:

• — What are you writing about?
• - About grandmothers.
• - I just wanted to ask: how are they there?

We'll definitely visit tomorrow.

P.P.P.S. Another day has passed. Nobody calls anyone. Grandma again justifies her granddaughter: “Yes, she rarely calls, once a week.” And her friend is in the same situation. Like this… attention deficit and communication in the elderly exists. It hurts their health and peace of mind.

What is care? It seems that we have been familiar with this word since childhood, but sometimes it is still quite difficult to define it. Are we confusing care with giving attention? This term is commonly understood as any action, the purpose of which is the protection and well-being of any living beings, often defenseless or weak. But the circle of wards can be interpreted very broadly, vaguely. There is even care for items that require complex care, such as computers or cars. But in this article, we will focus mainly on paying attention to living beings.

Historical definition

The ancient Romans knew about what care is. In Latin, there are even two whole words for these actions. These are tutio and tueor. The first of them means protection, protection, care. The essence of the second is reduced to the concepts of "look after, observe." In Roman law, the "master's eye" was given more importance. The fact is that property was of great importance in this ancient empire. It has been interpreted very broadly, often including children, slaves, and the family in general. A prudent attitude to property, including living property, was a feature not only of a good owner and master, but also of a Roman citizen as such. Cicero also wrote that a person who does not care about his small community, that is, his family, will not appreciate the good of the state. Therefore, the squanderer of property - the "prodigal son" from the Gospel - was equated with the insane.

Philosophical definition

What is care from a thinker's point of view? In German philosophy, this term has moved from the category of ethics to the category of universals. This is especially true for existentialism. Care in this philosophical direction was first considered by Heidegger, who recognized it as the basic sense of human existence. People are constantly in anxiety and fear for themselves, their loved ones, property and plans. Therefore, care is the main mode and reason for their activity, sometimes completely meaningless. After Heidegger, other European philosophers of this trend, in particular Sartre and Camus, began to write about this ethical concept, but they gave it a more practical meaning. The concept of "last concern", that is, anxiety about the ultimate goal of life, is also characteristic of the theology of late Protestantism. Paul Tillich, in particular, talks a lot about this. That is why care has, as it were, two definitions - positive (troubles, care) and negative (anxiety, fear). Both of them are reflected in explanatory dictionaries.

Political definition

The modern state is not only and not so much an apparatus of violence. It should also take care of people. First of all, this is a special attention to the needs of those groups of the population that are defenseless and not too competitive in relation to others. These are children, the elderly, people with disabilities, the sick, minorities who may become victims of discrimination. By the way the society, the people around them treat such groups, one can judge the level of their civilization. It is not for nothing that in many countries there are volunteers who visit the sick, children in shelters, selflessly help them. This is especially valuable in cases where the state does not have the means or political will to cover all those in need with its guardianship.

This word has many synonyms, each of which reflects some aspect of it. This is care, and zeal, and attention, and a desire to help. All these terms speak of a person's readiness to do good, of his responsiveness and empathy for others. Attention to the one who is taken care of also testifies to love and respect for him. No wonder writers and philosophers have repeatedly argued that these qualities help humanity to remain united and give us at least a tiny, but hope for the existence of a society based, if not on love, then at least on mutual respect. But there is a difference between these synonyms. For example, while caring can be instinctive, attention tends to be purposeful. In addition, care contains negative motives, such as fear. It is based on the fear of losing something now or in the future.

It is one of the basic instincts in both humans and animals. Weak and defenseless kids would not have survived without the care of their parents and elders. We can say that the presence of this instinct is a prerequisite for the preservation of the genus or species. Psychologists notice that such care is most often characteristic of women. It comes from within, not from without, and is carried out as a result of a strong desire. When it comes to men, they often talk more about duty and responsibility in such cases. But, of course, human care for offspring is not only an instinct. Love, cultural paradigm, and social role models can all be mechanisms for the manifestation of child care.

We are all subject to aging. Even very active parents, when old age comes or overcome inevitable illnesses, become slow, sometimes it is difficult for them even to move independently. Then they become dependent on us. And it's not about money, but in our presence, a kind word. People who are approaching death step by step need our love very much. And we have to take care of them, enter into an inverse role, become the parent of our own father or mother ourselves. And we do not always succeed in being caring and gentle towards them. After all, modern society is often a collection of lonely egoists. And we always have no time, we have our own anxieties, we brush off our elderly parents, transferring everything to “later”. And that moment may never come. Therefore, a truly caring mother should not forget to develop in her children empathy and a desire to take care of the weak and help them.

Pet Care

This kind of attention and love is an extremely necessary quality. After all, your pets are like children completely dependent on you who will never grow up. Dogs and cats should be combed regularly, properly and balancedly fed, regularly taken to the veterinarian, not beaten, of course, but educated. And most importantly - pay attention to them, talk to them, play, walk and remember that you are responsible for them! Such care is most often disinterested. If in a situation with caring for children or parents, one can talk about instinct or social respect, that is, about worries about their future or status, then, taking care of dogs and cats, especially the sick and old, people often do not receive either social or material benefits. on the contrary, they lose them. This means that at its core, caring has selfless motives.

What does lack of care or its excess lead to?

Lack of attention and lowering the threshold of responsibility, especially in relation to children and animals, can turn into disastrous consequences. This is a thesis that does not need any proof, it is obvious. We contemplate every day the results of such behavior. Neglected children and abandoned animals are just the tip of the iceberg. Diseases, death, including early death, aggressiveness, hidden or obvious hatred of one's own kind - these are the main consequences of a lack of attention to living beings. But if care is shown too intensely and out of place, then this can also lead to negative consequences. Often the one who receives such attention takes it for granted and stops thinking about independent living. Such a person can become a real domestic tyrant. On the other hand, a too caring mother, who takes care of children at every turn and does not want to come to terms with the fact that they are growing up, suppresses their will. They either grow up spineless and incapable of making independent decisions, or they begin to protest in adolescence, and then real family wars begin in the house. Therefore, care should not develop into humiliation of either the one who is being taken care of or the one who shows attention.

A serious illness is a misfortune. A bedridden patient, one way or another, experiences his misfortune, he is a victim of circumstances. But it so happens that his relatives, who are forced to take care of a bedridden patient for a long time, begin to consider themselves victims of circumstances and feel sorry for themselves.

We will tell you several stories of domestic "heroism" and domestic "betrayal" - after all, this is how public opinion judges those who face a choice: leave a bedridden patient in home care, or give them to a specialized institution. “Sacrificial help, so revered by public opinion” is one extreme side of the problem, the cold “pushing out” of the patient from the sphere of family forgotten is the other.

We must try to avoid both extremes. And the middle - "settle in." All possible variants of the “custodian-custodian” relationship are commented on by psychologist Svetlana Vladimirovna Gutyar, who provides consultations at the Alexander Nevsky Church (Kaliningrad).

The first story: about the flow of love, the breadth of the soul and pride

Our Victor has a large four-room apartment in Samara, and life is constantly in full swing in three rooms. Son Yurka is already finishing the eighth grade and is more interested in meeting girls than in his childhood hobby - models of warships. Vitya himself, a professional TV journalist, sometimes goes on business trips, and then his wife Zhenya gathers her friends for bachelorette parties. And when Zhenya has night shifts at the clinic, Vitya readily provides friends and buddies with a place for beer parties. Well, this family enjoys spending the weekend together - both outside the city, and in the sports center, and just in the cinema. Exemplary, in general, family. And Vitya also has a mother. Mom lives in the fourth room of an old apartment built by Stalin. Vitya's mother has been paralyzed for almost twenty years.

When I first came to visit, Vitya led me to the bed with the words: “Mom, look, this is my St. Petersburg colleague Veronika, I once told you about her.” I'm ashamed to admit it, but I tried to get out of this room as quickly as possible. Did this woman see me? Don't know. There was no reaction. And I was embarrassed and a little scared: “Vit, does your mother understand what you are talking about with her?”. “I don’t know, doctors convince me that she should perceive speech, but I have a feeling that she has long been closed in her own separate world, and does not notice us. But, just in case, I talk to her a little. You never know, maybe it helps her, - Vitya is already talking about this in the spacious kitchen. - And the rest is very simple and monotonous. In the morning we feed, change diapers, turn over, wipe. In the evening we feed, change diapers, change position slightly again and wipe. With diapers, by the way, now it's easy. And before, when it was necessary to wash the diapers all the time, they suffered more.

"Do you love your mother?" - I already ask this after a while and on the phone. I couldn't ask such a question. “I love, probably,” Vitya answers completely without emotion, “but only I love the mother that I had in my childhood. And this woman is not associated with my mother. I understand that the one that lies on the bed is my mother, but I cannot accept this with my soul. But I remember my mother and, in memory of my mother, I take care of this motionless person. "And Yurka?" - I ask a new tactless question, and I myself understand his tactlessness. But Vitya replies even more calmly: “What, Yurka? When Yurka was born, his grandmother had been in bed for several years. Yurka can’t even judge, for him there never was a grandmother, she didn’t sing any lullabies to him and didn’t tell fairy tales.

This is such a story - love and rejection at the same time. Is she typical? I ask Svetlana Vladimirovna Gutyar about this.

- Svetlana Vladimirovna, which decision is still more reasonable: to take care of a sick relative at home, or to place him under the supervision of professionals in a medical institution? After all, to take care without calculating the strength of the soul does it mean to drive “your patient into his separate world”?

I believe that the answer to this question is very individual for each individual case. See what happens: each disease leaves its mark on the personality of the patient. Each disease requires its own care - of varying severity and complexity. Yes, and we, relatives, each with their own psychological characteristics, and each of us has our own very difficult and not easy sides of character. And it is precisely on the basis of this totality that it is worth deciding how to care for the patient, where and to whom. It is worth thinking very carefully about these questions, weighing all the pros and cons before making a decision. Perhaps it will be complex - somewhere you can cope on your own, somewhere you can use the services of, say, a nurse.

I have a good friend, she is now about sixty, she is already inspecting the fourth relative in the last twelve years of our acquaintance with her. At first it was her mother, bedridden after a stroke. My friend took care of her on her own. Then, after the death of her mother, her father became seriously ill and took to his bed. Then the friend realized that she herself was no longer able to overpower the care of him and for the first time resorted to the help of paid qualified nurses, from time to time she put her father in the hospital if the situation required it. So he died in her arms. Three months later, her mother-in-law fell ill. Now she is examining her father-in-law, a very sick person, nurses come to her house, there is a nurse. When necessary, he puts the old man in the hospital.

What I like about this brave woman is that, despite her difficult character, she treats her sick relatives very lovingly, attentively and patiently - she reads books to them, sits by their bed for a long time, does a massage or simply strokes her hand, talks about what interesting things happened to her. And for all that, he still leads an active life: he helps to design and build churches, paints children's rooms in hospitals, attends courses, and is engaged in creativity. Once again, I want to note that my friend is far from being an ideal person, she has her own complexities of character, but what’s interesting is that it is caring for sick old people that makes her calmer, evens out all the “bumps and ruts” of her character.

I have another example, when I myself advised one of my clients to place my mother in a private nursing home. Believe me, it is not at all easy for me to give such advice, rather it is even very difficult. But, given the circumstances of the lives of these two women, this decision turned out to be the lesser of all evils. The daughter could not cope with her mother's illness, which simply exhausted her, made their communication acute and nervous, misunderstanding and rejection between them erected a high and strong wall. And now things have changed a bit. Mother and daughter meet on weekends, the daughter sees that the mother receives professional care, that the mother is in a good mood, clean and well-groomed, and the mother sees the care and genuine love of her daughter.

You know, the main thing when caring is not to forget that our bedridden patients most of all need our attention and love. They need to be seen as a person, not a burden and a problem, they need communication that brings them some inner peace and balance, they want to feel that they are loved, that they are loved.

This is not easy for us carers to do. Very often, children's reproaches come out into the world: but for me, in childhood, were they really taken care of? Not everyone can deal with their grievances - but it is we who do not really deal with inner pain. In order to care for the sick with love, tenderness and patience, you need to be a person of a certain spiritual breadth and generosity, but it is precisely the spiritual breadth and generosity that we all sometimes lack so much! And this is not only the trouble of each of us, it is the trouble of the whole society. Look, now the goal of society is to find ease, to make life easier. Today's society is a society of consumers, and if so, then care and concern for anyone will be considered an obstacle in achieving the desired, will be a burden and a heavy “cross”. How will such a person take care of a bedridden patient? At best, it is formal: to give medicine and food, while completely ignoring friendly communication and the manifestation of any feelings. And in the worst case, anger, depression, resentment can settle in the house, which is useful to few people even in a healthy state, and even more so it is very harmful for a bed patient.

It is clear that people who act differently, "like human beings", feel a bit like heroes. One of my clients said a very interesting phrase the other day: “We don’t leave our own!” It was she who commented on the fact that she is now caring for her sick mother and father at the same time, and at the same time helps in caring for her paralyzed mother-in-law. This woman is thirty-five years old, she has a family, two children and a job. She manages everything. Yes, she is exhausted, but she loves her family, and does not agree to part with them, no matter what sacrifices her departure requires. But at the same time, in our conversation with her, I had to put her in front of the realization of who for her stands behind the word “friends”.

The main thing here is to wisely distribute forces and your capabilities, because, having gone headlong into caring for the relatives of the older generation, you can lose sight of the younger generation. And thus, the husband and children may not fall into the category of "their own", and may be abandoned. “Full immersion” in care is also not a healthy state, such care can “strangle” a bedridden patient, turn him into a “small and ignorant child”, which will lead to the fact that the caregiver will completely ignore the requests and desires of the patient, attributing it to that, they say, only he knows what is good and what is bad. My point is that too much is just as bad as too little. In caring for the sick, we always have to balance, striving for the golden mean, otherwise we risk slipping either to the “Arctic cold” of formalism, or to the “suffocating care” of super-care.

The point here is to accurately determine your value priorities (“without which you won’t feel like a person”) and the limits of your capabilities and strengths. Have you noticed how everything in this world works naturally and harmoniously? If you have a low threshold of patience, and the will is poorly developed, then you probably have something else that will help you in caring for your sick relative. It could just be a well-paid job, for example, or the ability to quickly recuperate. Such a job, like this ability, will give you the opportunity to open a job to care for your relative, which in itself solves the problems of several people at once: you, your family, a sick relative, and that nurse who needs such a job. But if you do not have these opportunities, then there certainly are others - believe me, the world is arranged very reasonably, and if the Lord gives you a test, then He gives you support, resources and opportunities so that you can overcome this test. But for this you have to accept the problem, and reasonably approach its solution, based on the knowledge of your values ​​and yourself.

The second story: a bedridden patient and children

Inna firmly believes that a child should live in a prosperous family, and refers to the fact that even psychiatrists and psychotherapists forbid involving children in the care of seriously ill patients. Inna's mother is either in the hospital or in the hospice: where she can determine at the moment, she takes her there for a while. “Yes, yes, I know,” she says, “and my friends, and at work, at the factory, also believe that only relatives should look after, and strangers are worse. But my mother, by the way, for a long time does not care who does it, she has a mess in her head. All she needs is food and a clean diaper. She is not with us, she is already heading into different places and times. And I don't want my little daughter watching all of this on a daily basis." Inna's daughter is an excellent student, winner of competitions and school olympiads. This girl has a great future for sure.

Igor sings chanson. Not that he is a very well-known performer, but there are fans, Irinka, his wife, also works in the field of culture, and they started taking their daughter from kindergarten to dance classes and theater circles. They are now taking Igor's mother to the hospital.

“Don’t even push, Veronica, I don’t need to read sermons,” my friend immediately gets into a protective pose, deciding that I want to have another educational conversation with her, “don’t think that it’s easy for me to overcome the stress that you experience at the sight of a lying , helpless patient. But I will not pull such a test, I will not have enough strength. A friend's mother-in-law was in a hospice, and they looked after her quite normally - the main thing is to pay extra on time. When she was unable to eat on her own, she was fed through drips, supported as much as possible, and there were no bedsores. The man passed away with dignity, and his relatives did not have time to get tired of her and hate her. It is possible to take care of such patients at home so as not to feel remorse in front of them, but I am more worried about the pangs of conscience in front of my small child, I do not want her to grow up in such conditions. I have to choose between a worthy death for my mother-in-law, or a worthy life for my daughter.”

And I was not going to educate Irina. I just asked Irina her opinion. But, apparently, the decision was not so easy for Irina, if she immediately began to make excuses? Although, maybe I imagined it.

And again I need advice, and I turn to Svetlana Vladimirovna:

- If there are children in the house, how to build their relationship with bedridden patients? Attract to care, try to breed in different aspects of life, pretend that nothing special is happening?

There is no single answer to this question either - each case is unique, as is each family that faces such a problem. Yes, there are times when a relative suffering from a particular disease may show aggression towards children, or set a bad example for children, then, naturally, it is worth protecting children from such communication.

In other cases, it is worth teaching children to show care and attention in ways that are feasible for them, according to their age capabilities.

Once, a Dagestani shared wisdom with me, it goes something like this: “If you shoot a gun at the past, then the future will shoot at you from a gun.” I would like to comment on this wisdom with the following case from life.

Once a young woman came to me for help, she had problems with carrying a pregnancy, and the doctor sent her to me. Gradually, in the course of therapy, she told me her “family secrets”. So, she lived in a fairly wealthy family, in her own house. There was one room in this house, which her mother tried to enter as little as possible: there was a paralyzed old woman - my client's grandmother. This old woman could not walk or talk, but she understood everything. The old woman was looked after in the morning and in the evening by her son-in-law, the father of my client - he changed the sheets, fed, gave medicines, but the daughter was in her room no more than twice a week and did not let the children go there. Why this was so, the client did not know, she was small then - she was no more than nine years old at the time when her grandmother died, having lain alone in a room for at least seven years.

Many years passed, but this woman, each time pregnant, fearfully expected that her daughter or son would treat her in the same way as her mother treated her grandmother. And she could not forgive her mother for her coldness towards her grandmother, which completely poisoned and destroyed their relationship, depriving them of the understanding and love that both these women needed.

I myself grew up next to a bedridden, seriously ill grandmother. From childhood, we were taught to help our grandfather in caring for our grandmother: those who were older cleaned the house, went to the pharmacy and the store, those who were younger washed the dishes and did small tasks. We loved our grandmother very much, felt sorry for her as best we could, brightened up her day with our childish chirping about childish trifles, and on the best days she could tell us a fairy tale, teach us prayer, or sing softly to us in a weak voice. We all still remember those days with warmth and joy, none of the four of us considers ourselves somehow deprived or oppressed in our distant childhood. Each of us keeps deep in our hearts a lesson in love given to us by our grandparents.

– And what happens to the child's psyche under the influence of such a lifestyle?

You see, the child's psyche is like a sponge, it absorbs everything that happens around it. If a child sees that caring for a bedridden patient in his family is considered the norm, that the veil of tragedy and hopelessness does not hang in the house, that everyone in the family treats the patient with understanding and care, then the child will perceive everything that happens properly. At the same time, growing up, he will be sympathetic to the fact that older people get sick more often, that they are weakening and need help and attention.

But if a child grows up in an environment where a bedridden patient is excluded from life and relations with him are reduced to a minimum, then the outcome is completely different - rejection, rejection of old age and illness will settle in the soul of this child, such a child will strive to avoid sick and aging people, he will be afraid of his own illnesses, his helplessness and old age.

The third story: sacrifice or help from a specialist?

And Oleg's wife left. Well, I couldn't. Oleg was over forty, and his wife was no more than thirty. And, marrying him, she planned the birth of a child and family trips to resorts. But Oleg's father fell ill almost immediately after the wedding, and Oleg moved him to his place. At first, it even seemed right: they combined the footage of two old apartments, exchanging them for one new, more spacious one, added father’s old-age and disability pensions to the family budget, since the bed patient did not need much, received help from other relatives, grateful that all Oleg took care of himself. And three years later, Oleg's wife realized that patient care is becoming long-term (in her understanding, almost endless). She no longer spoke about any childbirth, and her friends convinced that giving birth in such conditions is to deprive the child of childhood, to bring him, in fact, to sacrifice. And Oleg did not want to take his father to the hospital.

“You see,” Oleg explains his position to friends and acquaintances every time, “in the hospital, such people are doomed to a painfully long death. Here, probably, you will not get any joy from the newfound freedom. Problems with swallowing, bedsores, intoxication of the body will begin. And then what? No one there, in the hospital, will turn over, wash and give semi-liquid pureed food in small portions in time. I have read everything on the Internet. Even if we hope that there will be no complications, then the simplest questions arise. If diapers are changed, how many times a day? Will they wash? Will the medicine be given on time? And somehow I'm still not very successful in sending all these questions away and starting to enjoy the promised freedom. Convinced? And friends usually nod: "Convinced, convinced." And I think that many of them are asking the question: “What would I do?”. And they continue to cheer Oleg on. And Oleg still dreams of a house full of children.

I call a doctor friend with a question. “There is an opinion that sacrificial mercy, so revered by public opinion, can often harm both the guardian himself and, by the way, the ward, - Andrei Petrovich says serious things in a serious voice. - After all, high-quality patient care, especially in the case of a severe somatic or mental state of the patient, requires high qualifications, a large amount of knowledge and practical skills. And an unprepared relative, with all the care, most likely will not be able to fulfill all the duties at a high professional level. Many will say that love will atone for a lack of knowledge, but it is possible to put a dropper incorrectly even with great love.

“Stop, stop,” I interrupt him, “so, Andrei Petrovich, are you also in favor of handing over your loved ones to state institutions?” I pronounce this “state institutions” with a single exhalation and I understand that I also spoke in official official language. “Well, what are you,” the doctor is surprised, “I’m not talking about that at all, I’m talking about home care with the involvement of qualified help.” And then we discuss the pros and cons of this approach for a long time.

There are three main reasons why people refuse nursing care for the sick at home. Fear that a stranger will not treat a beloved relative with due attention and care. Fear of letting a stranger into the apartment and leaving unattended, even if recommended by a clinic or medical company. The high cost of the service.

Psychologist Gutar does not argue with Andrey Petrovich.

- Svetlana Vladimirovna, the patronage nurse in the house - is she a stranger or the most important assistant and almost a member of the family?

You know, a couple of years ago I myself had to invite a nurse to our family to help care for a sick father-in-law. Of course, I would very much like a real helper to come to your family who would share all the hardships with you. However, finding such a person, although possible, is not easy. Yes, we are all people with character, and we all have our own views on life. It’s sometimes not easy to negotiate with relatives, and then a stranger enters your house And not only helps, but also sees the whole structure of your home life from the inside, and besides, he has his own personal opinion on everything! It all depends on the hostess and the owner, whether they can accept a stranger, and on what rights: “almost a family member” or something else. The hostel is a difficult thing, but the main thing to remember here is: for what purpose do we invite a nurse to our house - in order to alleviate the suffering of the patient, or “so that we have parcels”. The human factor is not a simple thing at times, and conflicts happen, and misunderstanding, but gratitude and acceptance are gradually born, and even then it may not be far from a “family member”.

- How do patients perceive their forced dependence? Can types be identified?

As I mentioned above, the disease rarely paints someone, and often not the best aspects of the character of the sick person become aggravated in diseases. Here the matter is both in the disease itself, which leaves an imprint on the personality of the patient, and the matter is in the sick person himself, or rather, whether he can accept his illness, come to terms with it and with the restrictions that it imposes on him. There are stages of acceptance of the disease, and so, very often a sick person can “get stuck”, for example, at the stage of protest or depression, and then, naturally, the behavior of a sick person will be determined by his perception of his condition.

However, if the patient finds the strength and courage to accept his illness, then his character and behavior can change for the better. There is a lot of evidence for this, I am constantly encouraged and inspired by my clients, women with cancer from the Vita Society. At first they came to us for classes in a different state. But gradually their attitude to illness and life changed, many began to reconsider their relationships with loved ones, learn to build relationships in a new way, with love and attention to their loved ones, learn to overcome their egoism and fear.

But as for the types of behavior of patients, I think it is worth talking about this in more detail next time separately.

- Why does one of the spouses often leave families where there are bedridden patients? What is it? Failed the difficulty test? Or are there other explanations?

Here it may be not only that someone did not stand the test of difficulties, it may be something completely different. For example, the caregiver himself can isolate himself from his loved ones, believing that it is right to behave in this way, that it is simply necessary to give everything to the sick person, to the detriment of other family members. At the same time, he may mistakenly believe that these other family members should come to terms with this circumstance and even begin to respect and appreciate him more, sacrificing himself in the name.

It's a matter of misplaced priorities. It turns out that the caregiver will direct all attention in one direction, completely depriving other members of his family of his attention. Those, in turn, will feel abandoned and not loved, they will definitely want understanding and acceptance, which they will go to look for on the side. We must not forget about the healthy - at the time of caring for the sick.

Yes, I agree that in our time of striving for a comfortable life, some will not be able to bear the burden of caring for a sick bedridden person. I think that families should openly speak out on such topics and discuss various options for caring for the sick, and the possibility of their living either in a family or in a specialized institution.

I think that there would be fewer such divorces if people could honestly talk about their weaknesses and fears, could openly discuss everything that worries and worries them.

And yet, the psychological climate in the family plays a very important role in whether a family survives or breaks up while caring for a seriously ill relative. And this climate is created by a woman. So, if a woman does not dramatize, and creates an atmosphere of understanding and acceptance around herself, then this will in any case have a positive effect on strengthening intra-family ties.

But if such circumstances of life seem to a woman unfair, unbearably difficult, then she willy-nilly will sow around herself a state of depression, melancholy and hopelessness. A man cannot be in this state for a long time, because he begins to consider himself responsible for not making everyone happy, begins to blame himself, which contributes to the growth of isolation and misunderstanding, and the situation in the house is heating up even more. At best, the spouses will begin to live a “parallel” life, each will arrange for himself “quiet innocent joys”; in the worst case, such a family will fall apart.

- Some say: "Devoting all my time to caring for the sick, I am wasting my life and the life of my growing child in vain." How true and justified is this position?

You know, for me this position is, to put it mildly, very strange. Works of mercy require active compassion, great self-sacrifice, long-suffering and determination from the relatives of the sick. You understand that only a loving heart is capable of such a thing. But not even every loving heart has access to feats. We are not born merciful, we become so under the influence of upbringing or the hardships of life. So, what can be more valuable than love? What can replace love for us? To love and be loved is a basic human need. I agree, to be loved, to receive love without giving anything in return - is now becoming the leitmotif of the lives of a huge number of people.

And oddly enough, saturation and satisfaction with life can only be achieved by learning to give, to love, to care, to be merciful. So it turns out that caring for the sick person, to the best of his ability, even contributes to finding the meaning of being, and not just living out his life mediocre and empty, spending it chasing the mirage of a “glossy and advertising” life.

Yes, while caring for the sick, we will be able to see something less, we will be able to buy something less, but it's worth it!

However, each of us has our own choices, our own values, and, let me repeat: what is good for one, will not be acceptable for another.

- Mercy without experience or experience without unnecessary sentimentality, what is more important and useful?

I think neither of these is acceptable. Mercy without experience is like a child who, even with the best of intentions, will definitely do something wrong and to the detriment. And experience without sentiment is a very cold and prickly thing, and can hurt much more than we can even imagine. Let me repeat: measure is good everywhere, responsibility and timeliness are needed everywhere. Mercy should not be ashamed of its inexperience, and then experience will grow faster. But even an experience devoid of sentiment should remember that “a kind word is also pleasant for a cat,” and for a sick person, any kind word is like a sip of living water.

Veronika Sevostyanova

The purpose of my talk today is to highlight the typical problems that older people have and how they affect us caregivers.

First, let's define the main concept. Dementia– this is acquired dementia. That is, when the human brain has already formed, and then something happened to it. We still use the word "oligophrenia" to this day. Oligophrenia- this is dementia that arose in the early stages of brain formation, and everything that a person “acquired” later is called dementia. It usually happens after 60-70 years.

Rating of typical misconceptions. "What do you want, he's old..."

1. Old age is not treated.

For 14 years I worked as a district geriatric psychiatrist in Korolev in a regular dispensary. Once he was, perhaps, the only person who regularly went from house to house with people suffering from dementia.

Grigory Gorshunin

Of course, a lot of interesting experience has accumulated. Often the patient's relatives are faced with the position of doctors: “What do you want? He's old..." The most brilliant answer, in my opinion, was given by one relative of an elderly grandmother, who said: “What do I want? I wish that when she died, I had less guilt. I want to do what I could do for her!”

The doctor always wants to be efficient, he wants to cure the patient. And old age cannot be cured. And the illusion is created that there is nothing to do with old people at all. It is with this illusion that we must fight today.

There is no diagnosis of "old age", there are diseases that need to be treated, like any disease at any age.

2. Dementia does not need to be treated because it is incurable.

In this case, any chronic diseases do not need to be treated, and yet about 5% of dementias are potentially reversible. What does "potentially reversible" mean? With the right treatment early on for some types of dementia, dementia can be cured. Even with irreversible processes, at an early stage, dementia can recede for a while, and symptoms can decrease. If treated appropriately.

Is 5% a little? A lot on a general scale, since according to official data in Russia there are about 20 million people suffering from dementia. In fact, I think this figure is underestimated by one and a half to two times, since dementia is usually diagnosed late.

3. "Why torture him with" chemistry "?".

Also a violation of ethics: it's not for us to decide all this. When you yourself get sick, do you not need to be “tormented” with medicines? Why can't an older person get the same help as a younger one? Some amazing hypocrisy, relatives say: “Let's not torture our grandfather with chemistry”, and then. When grandfather infuriates them, and brings them to a "white heat", they can hit him, tie him up.
That is, you don’t need to “torment with chemistry”, but can you beat? An elderly person cannot go to the doctor himself, and we must take on this function.

People endure for weeks, sometimes months, terrible behavioral disorders and sleep disturbances due to the dementia of their relatives, and then, staggering, they come to a psychiatrist and say: “Doctor, we don’t need anything, let him just sleep.” Of course, sleep is very important, it needs to be organized, but sleep is the tip of the iceberg, if you just improve sleep, this will not help a person with dementia much.

Insomnia is a symptom. And therefore, it is possible to put a grandfather to sleep, but it is impossible to help him from dementia in this way.

For some reason, the environment of the patient - close people, nurses, nursing staff, some neuropathologists and therapists - think that it is very difficult to improve sleep, remove aggression, remove crazy ideas. In fact, this is a real challenge. We cannot cure a person, but to make sure that he is comfortable for us in care and at the same time he feels more or less good himself is a real task.

Outcome of delusions: Unnecessary suffering of the patient and his environment.

Aggression, delusions, behavioral and sleep disturbances, and much more can be stopped, and the development of dementia can be stopped for a while or slowed down.

3 D: depression, delirium, dementia

There are three main themes that caregivers and physicians face in geriatric psychiatry:

1. Depression

• Depression is a chronically low mood and inability to enjoy.
• Common in old age
• At this age, it can be perceived as the norm by the patient and others
• Strongly affects all somatic diseases and worsens their prognosis

If a person, no matter what age, is chronically unable to experience joy, it is depression. Everyone has their own experience of old age. I would very much like that with my help we will form an image of old age a la Japan, when we save up money in retirement and go somewhere, and not sit on a stool straight.

In the meantime, the image of old age in our society is rather depressing. Who do we represent when we say "old man"? Usually a bent grandfather who wanders somewhere, or an angry, restless grandmother. And therefore, when an elderly person has a bad mood, it is perceived as normal. It is all the more normal when old people who have lived to be 80–90 years old say: “We are tired, we don’t want to live.” It is not right!

As long as a person is alive, he should want to live, this is the norm. If a person, in any situation, does not want to live, this is depression, regardless of age. What's wrong with depression? It negatively affects somatic diseases and worsens the prognosis. We know that older people usually have a whole bunch of diseases: type 2 diabetes, angina pectoris, hypertension, knee pain, back pain, and so on. Even sometimes you come to a call, you ask an elderly person what hurts, he says: “Everything hurts!”. And I understand what he means.

Both old people and children suffer from depression in the body. That is, in fact, the answer “everything hurts” can be translated into our language like this: “My soul hurts, first of all, and everything else comes from that.” If a person is depressed, sad, his pressure jumps, sugar, until we remove this sadness and depression, it seems unlikely to normalize other indicators.

Bottom line: Depression is rarely diagnosed and treated. As a result: the duration and quality of life is less, and others are worse off.

2. Delirium (confusion)

1. Clouding of consciousness: loss of contact with reality, disorientation, with chaotic speech and motor activity, aggression.
2. Occurs often after injuries, moving, diseases
3. Often occurs acutely in the evening or at night, may pass and resume again
4. The person often does not remember or vaguely remember what he did in a state of confusion.
5. Worsened by improper treatment

We encounter the topic of delirium in people at a young age, mainly with prolonged use of alcohol. This is "delirious tremens" - hallucinations, acute delusions of persecution, and so on. In an elderly person, delirium may occur after physical or psychological trauma, moving to another place, bodily diseases.

Just the day before yesterday, I was on a call to a woman who is already under a hundred years old. She always lived almost independently - with a visiting social worker, relatives bought food. She had dementia, but mild, until some point it was not critical.

And so she falls at night, breaks her femoral neck, and on the very first night after the fracture, confusion begins in her. She doesn’t recognize anyone, she screams: “Where did you put my furniture, my things?” She starts to panic, get angry, get up with her broken leg, and run somewhere.

A common reason for the start of confusion is moving. Here an old man lives alone, serves himself in the city or in the countryside. The environment helps him - neighbors buy groceries, grandmothers come to visit. And suddenly they call relatives and say: “Your grandfather is weird.” He gave to the pigs what he gave to the chickens, to the chickens what he gave to the pigs, he wandered somewhere at night, barely caught, and so on, he talks. Relatives come and take grandfather away.

And here a problem arises, because grandfather, although he did not cope well with his chickens and pigs, at least knew where the toilet was, where the matches were, where his bed was, that is, he somehow oriented himself in the usual place. And after the move, he does not orient himself at all. And against this background, usually at night, confusion begins - grandfather is torn "home".

Sometimes relatives, stunned by such perseverance, really take him home so that he calms down about the chickens ... But this does not lead to anything, because in the next entrance the same grandfather is eager to “go home”, although he lived in this apartment all his life .

People, at the moment of confusion, do not understand where they are and what is happening around. The confusion often comes on acutely, in the evening or at night, and may go away by itself in the morning after sleep. That is, at night they call an ambulance, the doctor gives an injection, says: call a psychiatrist, and in the morning the patient wakes up calm and does not remember anything. Because confusion is forgotten (amnesic), the person does not remember, or very vaguely remembers what he did in a state of confusion.

Confusion is most often accompanied by psychomotor agitation: speech, motor, usually occurs at night, and, which is especially unpleasant, is aggravated by incorrect treatment.

When sleep is disturbed in the elderly, what drug is usually advised by a therapist, a neuropathologist? Phenazepam is a benzodiazepine tranquilizer. This drug can treat anxiety and insomnia. He soothes and soothes.

But with confusion (due to organic brain disorders), phenazepam acts the other way around - it does not calm, but excites. We often hear such stories: an ambulance came, gave phenazepam or made relanium intramuscularly, grandfather forgot for an hour, and then began to “run along the ceiling”. This whole group of benzodiazepine tranquilizers often works the other way around (paradoxically) in old people.

And about phenazepam: even if your grandparents use it within reasonable limits, keep in mind that, firstly, it is addictive and addictive, and secondly, it is a muscle relaxant, that is, it relaxes muscles. Elderly people, when they increase their dose of phenazepam, getting up, for example, at night to go to the toilet, fall, break their hips, and that's it.

Sometimes they also begin to treat insomnia or confusion in grandmothers with phenobarbital, that is, Valocordin or Corvalol, which contain it. But phenobarbital, although indeed a very strong sleeping pill, anti-anxiety and anticonvulsant, is also addictive and addictive. That is, in principle, we can equate it to narcotic drugs.

Therefore, in Russia we have such a specific phenomenon as korvalolshchik grandmothers. These are grandmothers who buy a huge number of bottles of Valocordin or Corvalol in a pharmacy and drink several of them a day. In fact, they are drug addicts, and if they don't drink it, they a) won't fall asleep; b) they will develop behavioral disorders resembling delirium tremens in an alcoholic. Often they have slurred speech like "porridge in the mouth" and a wobbly gait. If you see your loved one regularly drinking these over-the-counter drugs, please look into it. They must be replaced by other drugs without such side effects.

Bottom line: when confusion is not addressed in the early stages, they do not look for causes, they are not treated in the same way, as a result - the suffering of the patient and the whole family, the flight of nurses.

3. Dementia

Dementia is acquired dementia: disorders of memory, attention, orientation, recognition, planning, criticism. Violation and loss of professional and everyday skills.

• Relatives, and sometimes even doctors, “notice” dementia only at advanced stages
• Mild and sometimes moderate disorders are considered the norm in the elderly and senile age.
• Dementia can start with personality disorders
• Often the wrong treatment is used

What do you think, if you bring an average elderly person in their 70s with a memory impairment and an orientation to an appointment with a neurologist, what diagnosis will he most likely receive? He will receive a diagnosis of "dyscirculatory encephalopathy" (DEP), which, translated into Russian, means "a disorder of brain functions due to impaired blood circulation through its vessels." More often than not, the diagnosis is wrong and the treatment is wrong. A non-stroke, but pronounced form of the course of cerebrovascular disease (DEP), is a severe and relatively rare disease. Such patients do not walk, their speech is impaired, although there may not be asymmetry in tone (differences in the work of the muscles of the left and right half of the body).

In Russia, there is a traditional problem - overdiagnosis of vascular problems of the brain and underdiagnosis of so-called atrophic problems, which includes Alzheimer's disease, Parkinson's and many others. For some reason, neuropathologists everywhere see problems with blood vessels. But if the disease develops smoothly, gradually, slowly, most likely it is not connected with the vessels.

But if the disease develops abruptly or spasmodically, this is vascular dementia. Quite often, these two conditions are combined. That is, on the one hand, there is a smooth process of dying off of brain cells, as in Alzheimer's disease, and on the other hand, vascular "catastrophes" also occur against this background. These two processes mutually "feed" each other, so that even yesterday a well-kept old man can "break into a tailspin".

Relatives and doctors do not always notice dementia, or notice it only in advanced stages. There is a stereotype that dementia is when a person lies in a diaper and “blows bubbles”, and when, for example, he loses some household skill, this is still normal. In fact, dementia, if it develops very slowly, most often begins with memory disorders.

The classic case is dementia of the Alzheimer's type. What does this mean? A person remembers events from his life well, but he does not remember what happened just now. For example, at the reception I ask an elderly person, he recognizes everyone, knows everything, remembers the address, and then I say: “Did you have breakfast today?”. - "Yes", - "What did you have for breakfast?" - Silence, he does not remember.

There is also such a stereotype that dementia is something about memory, attention, orientation. In fact, there are types of dementias that begin with character and behavioral disorders. For example, frontotemporal dementia, or Pick's disease as it used to be called, can begin with a personality disorder. A person in the first stages of dementia becomes either complacently relieved - "the sea is knee-deep", or vice versa, very closed, self-absorbed, apathetic and sloppy.

You probably want to ask me: where, in fact, does that conditional border lie, between the still normal and already the onset of dementia? There are different criteria for this boundary. ICD (International Disease Qualification) indicates that dementia is a violation of higher cortical functions with a violation of household and professional skills. The definition is correct, but it is too vague. That is, we can apply it both at advanced and at early stages. Why is it so important to define the boundary? This moment is not only medical. Legal issues often arise: problems of inheritance, legal capacity, and so on.

Two criteria will help determine the boundary:

1) Dementia is characterized by criticism disorder. That is, a person no longer treats his problems with criticism - to memory disorders, basically. He does not notice them, or downplays the scale of his problems.

2) Loss of self-service. As long as a person takes care of himself, we can assume by default that there is no dementia.

But here, too, there is a subtle point - what does “serves itself” mean? If a person already exists in your care, but functions in an apartment, this does not mean that there is no dementia. It may very well be that it is already gently developing, it's just that a person in his usual environment does not detect it. But, for example, he cannot go and pay himself according to the receipt: he gets confused, does not understand what and where to pay for, is not able to count the change, etc.

Here is the mistake: mild and slow disorders are considered the norm in the elderly and senile age. This is very bad, because it is mild and slow disorders that can be effectively treated. If you bring your relative at an early stage of dementia, it can be managed with medications that don't cure dementia but are great at containing it. Sometimes for many, many years.

Bottom line: Dementia is diagnosed late, treated incorrectly. As a result, close people live less, worse, suffer themselves and cause suffering to others.

Where should you start if a loved one has dementia? A very unusual answer: taking care of the caregiver!

By normalizing the state of mind of the caregiver, we:

– Improving the quality of care;

– We carry out the prevention of “burnout syndrome” among relatives and carers. If you explain "on the fingers", those who are nearby go through the stages of aggression, depression and somatization;

– We keep good carers and health for our loved ones who bear the burden of care;

– If the caregiver works, we improve his performance and sometimes keep his job.

Does anyone have a version of why you need to start with yourself when caring for a loved one with dementia? Recall 3D, where depression comes first. The caregiver is actually much more vulnerable than the dementia patient.

And you still need to provide for the patient - socially, legally, medically. If you put the patient in the center, or rather, his illness, over time you will lie next to the patient. Only by normalizing the condition of the caregiver, we improve the quality of care and help the patient himself.

Burnout Syndrome has three conditional stages: aggression, depression, somatization.

Aggression - often as irritability, the classic version is asthenia (weakness, fatigue).

This is the phase of apathy, when a person no longer needs anything at all, he walks like a “zombie”, is silent, tearful, automatically cares and is no longer with us. This is a more severe stage of burnout.

Simply put, a person can simply die. The caregiver develops his own illnesses and becomes disabled himself.

It is impossible to cheat reality. If you care without taking care of yourself, then after a while you yourself will perish.

What can be done with the right treatment and care for a demented relative?

• Identify and treat "potentially reversible dementia" and depressive pseudo-dementia;
• Extend the life and quality of life of a loved one if dementia is incurable;
• Eliminate the suffering of the elderly, behavioral disorders, psychotic disorders;
• Save health, strength, work for caregivers and relatives.

In 5% of cases, dementia can be cured. There are dementias with hypothyroidism, with hyperthyroidism, with a lack of vitamin B-12, folic acid, normotensive hydrocephalus, and so on.

If we cannot cure dementia, we must understand that it takes, on average, four to seven years from the time of diagnosis to the death of our loved one. Why should we turn these years into hell? Let's eliminate the suffering of an elderly person, and save ourselves health and work.

Questions:

– If I notice some behavioral deviations in a relative, but she does not recognize this and does not want to be treated?

– In medical law, there is the Federal Law “On Psychiatric Care and Guarantees of the Rights of Citizens in its Provision”. I believe that all people who care for dementia patients, due to the difficult social and medical and legal situation, need to read and know this law. Especially about observation by a psychiatrist: how can a psychiatrist be invited, in what cases can a psychiatrist involuntarily send a patient to a hospital, and when to refuse, etc.

But in practice, if we see dementia, we try to start treating it as soon as possible. Since getting permission from the court for an examination is a very long time, and the disease progresses, relatives go crazy. Here it should be remembered that psychotropic drugs for dementia patients cannot be left on their hands. You need tight control. They forget to take them, or they forget that they took them, and they take more. Or they don't take it on purpose. Why?

1. Ideas of damage, which is formed against the background of memory impairment. That is, an elderly person, already seized with paranoid anxiety, takes his documents, money and hides them, and then cannot remember where he put them. And who stole? Either relatives or neighbours.
2. Ideas of poisoning. This problem can be solved if you start treatment with drugs in solution. Then, when this idea disappears in a person, he agrees to take drugs for memory voluntarily.
3. Inappropriate sexual demands. I tried to talk a little about this at the Conference. A very difficult topic. We are used to the fact that caregivers can sexually abuse helpless caregivers. But it also happens the other way around: deprived of criticism and “brakes”, the ward commits depraved acts towards minors, etc. This happens much more often than many people think.

– What can be the reason for the complete refusal of food and water in the later stages of dementia?

- First of all, it is necessary to find and treat depression.

1. Depression (no appetite);
2. Ideas of poisoning (changes in taste, poison was added);
3. Concomitant somatic diseases with intoxication.

1. If you have a replacement, the best way when you are tired is to leave a fast for a while. A replacement can be found if you set such a goal.
2. If it is impossible to leave and rest, we treat the “burnout syndrome” with medicines.

It must be borne in mind that caring for an elderly person is hard physical and moral work, which, for us, relatives, is not paid. Why else is burnout syndrome so relevant? If you were paid money for care, you would not burn out so quickly. Adequately paid care is the prevention of burnout syndrome.

But it’s even harder to rebuild inside, admit that your loved one is sick, take control of the situation into your own hands, and, despite fatigue and troubles, try to enjoy this life. Because there won't be another.

Age gives not only experience and wisdom. Over time, kind, sympathetic people with a good sense of humor, who can beautifully formulate their thoughts, can change beyond recognition. Often lived years make a person rude, unsociable and touchy. A few simple tips on how to communicate with elderly parents will help you get through a difficult period and provide loved ones with decent care.

The Importance of Good Communication with Elderly Parents

The life of each family is individual, and, of course, in addition to joyful events, it has a number of problems. Many people live with elderly parents (their own or husband/wife) and face misunderstandings, quarrels and growing tension in relationships. It is best to immediately figure out why the elderly person is dissatisfied, and try to come to an understanding.

With age, we do not cool off towards our parents. Just your own life experience and the rapidly changing environment make their own adjustments to the relationship. In fact, there is no such child who, over the years, ceases to love his parents, but their behavior often becomes the cause of quarrels and scandals. They may demand constant attention, despite your busyness, and take offense over trifles, including if you cannot be around. Adult children want to visit their parents as often as possible, but this is not always possible. As a result, resentment is ripening, the time of visits is reduced, which leads to psychological tension between dear and close people. Everyone who faced such a situation asked himself the question: how to communicate with elderly parents? How to become more tolerant, more restrained in relation to the changed behavior of the mother or father, and also how to help your relationship? Let's start exploring this difficult topic from the very origins of the problems.

Causes of dissatisfaction of older parents

Feelings of loneliness and abandonment

Probably, there are no older people who would not consider that they are abandoned by everyone. You can add to this age-related changes - sclerosis and partial memory loss. As a rule, older people are happy to communicate with their children, since this is the only outlet that connects them to reality. The opportunity to see loved ones often is the main joy in life, so you should not deprive them of this. They will be happy to hear about your victories and accomplishments, while often not remembering the essence of the conversation. There is so little free time in our lives, but always try to find a few minutes for such a conversation.

Desire to take care of your grown children

With age, parents are increasingly moving away from reality, and for them you remain babies that need to be taken care of. Don't get annoyed about this. You just need to accept reality as it is, and try to surround your dads and moms with care. Do not forget that before retirement, your loved ones had their own social circle, but over the years it has sharply narrowed and only you have remained in it. This situation often becomes the root cause of irritation and even aggression.

You will forever remain a child to your parents, and nothing can be done about it. Communication over the years will be built according to the usual pattern, and you, like many years ago, will be given advice on how to dress, what to buy and where to study/work. Don't make a tragedy out of this. Getting irritated at their remarks will only exacerbate the negative state of affairs. The desire to prove one's case will lead to nothing - only the negative will grow. A little tact, and you can easily get around sharp corners in a conversation.

Forgetfulness

Communication can be a big problem as older people don't remember what you were talking about just a few minutes ago. Problems may begin with the lights on, water on, or other dangerous forgetfulnesses, such as your address. This is due to changes in brain activity, so in such situations, it remains simply to increase control.

When communicating, an elderly person wants to talk about exactly those problems that seem important to him. Often such a conversation is like a broken record, because older people remember better what happened to them in their youth, and completely ignore the pressing problems. You shouldn't get mad at them for it, you just need to be more patient. Give your parents a few minutes and once again listen to a familiar monologue.

Vulnerability

Communication with older people often becomes a big problem, as they are very vulnerable and can get upset over trifles. Many, especially women, perceive any remark about their appearance or behavior as an insult. What is a trifle for you seems like a real tragedy to an elderly person, and the conversation can go in an undesirable direction. Tantrums, screaming and resentment often become the causes of nervous breakdowns. Try to keep tact in a conversation and not offend loved ones with an accidentally thrown phrase.

An older person's mood can change faster than spring weather. During the conversation, they can several times go from a state of excitement to sadness, joy or longing. Any reminder of what brings them pain can cause tears and resentment. Try not to hurt their feelings in the conversation. This will be the key to mutual understanding and good mood.

The need to talk about health problems

Remember that every passing year brings with it many age-related ailments. Communicating, we often perceive the complaints of pensioners as something insignificant. Remember that for them this is an important aspect of life, and talking about pills, tests and well-being is the price we have to pay for love and understanding. Only you can provide them with the necessary assistance in the fight against diseases, which will become more and more over the years. It is quite possible to listen once again to the description of diseases and not dismiss the problems of parents.

Rejection of the new

When communicating with people of age, we often encounter the fact that they categorically refuse to accept modern ways of housekeeping. They don't like the way you clean, cook, spend money, relax. They are familiar with the movies and music of their youth. Do not forcibly alter the taste, act intuitively, gradually accustoming parents to the perception of a new life. If you do everything abruptly, then nothing good will come of it. Scandals, resentments will begin, and you can lose your usual communication for a long time.

Dissatisfaction with relationships with grandchildren

Often the reason for the conflict is insufficient communication between your parents and your children. Many old people try to transfer their care and love to their grandchildren, because you are always at work. Adolescents often perceive such guardianship as an encroachment on their personal space. It is required to have a conversation and explain to the child that an elderly person also tends to be interested in the outside world and events, and try to establish intra-family communication together without scandals and quarrels.

Control your speech

In a conversation, we can do great harm with a few words. It is often difficult to maintain a conversation with a person of age, but remember that this condition is a consequence of the years you have lived. Skip the conversation topics that spoil their mood. Do not focus on the fact that one of their friends or neighbors has died - this can cause an emotional breakdown. Try to be less expressive in your comments. The conversation should be smooth and measured.

Don't focus on your help

Do not bother them with your advice, but rather help quietly. More recently, they were worried about your bad grades or torn clothes, and today you are already worried that your mother does not take pills, and your father tore off his lower back in the country. Try to surround them with maximum unobtrusive attention without moralizing.

Any supervision of parents can cause frequent conflicts. Remember how you resented them when they interfered in your school, student or personal life. More tact, and the conversation with relatives will go in the right direction.

Don't make an elephant out of a fly

When communicating, the words of parents that they did something bad do not always indicate a serious problem. Don't panic ahead of time. Try to get to the point with a few leading questions. At the same time, do not focus too much attention on the problem that has arisen. Elderly people are very suspicious and can then worry about trifles for a long time.

Show tenderness and love for no reason

Praise can work better than any medicine. A kind word can radically change the mood and save an elderly person from worries. Encouragement and praise of a son or daughter, words of love or just strong hugs will make the psycho-emotional background comfortable for a long time. Do not forget to say that they are the best parents, as well as grandparents, and this will help them take their minds off many problems. Never forget to say thank you. Gratitude for a person of age is a confirmation of his involvement in the life of loved ones. Remember: warm, affectionate words can quickly put out the flames of any quarrel.

Don't encourage old grudges

Sometimes you can find a way out of a difficult situation by looking from the outside at your relationship. Try to take your mind off the conflict if it has been going on for a long time. The essence of resentment may turn out to be so insignificant and petty that it is not worth focusing on it.

Let them feel their strength

Even a very old man must have his duties. Come up with a task that your parents can easily handle and fill their lives with meaning. Even simple work that you yourself do much faster and better will be very important for them and will make you feel your importance again.

Chat about everything

Talk more to older parents. They need to feel that they play an important role in your life. There is no need to choose topics specifically, for them everything matters. Even talking about traveling by public transport is a good topic for conversation. The main thing is that they do not get nervous.

Get Ready for Difficulties

Accept your parents for who they are. At their age, it is too late to change, and constant criticism of their actions will only cause irritation and resentment. Sometimes it is useful to close your eyes to some problems and not focus on them. Don't blame yourself if something goes wrong. Try to get to the heart of the conflict and solve the problem with a few kind words. Attention and love will surely be able to overcome any disagreement. Do not forget that your children are watching your relationship with dad and mom, and after many years you will have to take advantage of the fruits of upbringing.

The complex of club residences "Third Age" takes care of maintaining communication with parents

In our complex, each resident is surrounded by care and can count on the help of highly professional specialists at any time. The main concept is the adaptation of older people to a new worldview. Here you can stay for a short period of time or become a permanent resident. In the complex of club residences "The Third Age" the atmosphere is thought out to the smallest detail, and the staff knows exactly how to make the pastime as comfortable and convenient as possible. At the same time, conditions have been created so that guests get the maximum pleasure from every moment spent with friends and family. You can communicate with elderly parents both by phone and in person, coming to our country club.