Dr. Andrew Duxbury

Dr. Duxbury has an extensive background in community based geriatric programs. While on the faculty at the University of California he developed courses in geriatric health and wellness and founded an educational house call program to teach physicians in training the disappearing art of health care in the home environment. In 1998 he joined the faculty of gerontology and geriatric medicine at the University of Alabama where he is medical director of UAB geriatrics.

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Dear Dr. Duxbury,
Do you have any tips for (well screened and reliable) respite workers, hired by either a spouse or adult children, who provide good care for elders with dementia. When the family arrives home, the (confused) patient berates the worker and criticizes the family member for treating him badly.

The workers and the family have to realize that this situation and these behaviors will happen relatively frequently and, when it does happen, it is not a reflection on the care provided, or on the value or self worth of the competent adults involved. Unfortunately, it often pushes all sorts of guilt buttons and people get caught up in believing it.

Try drawing analogies to young children left with a baby sitter. Those who are parents may be familiar with the kids telling wild stories or bursting into tears when left with a sitter. There may be a few pangs of guilt or regret but they are quickly forgotten as the parents realize it is a necessary part of the maturing process for the child to learn that they can survive without mom and dad.

Families need to realize that leaving a dependent adult so they can get some much needed respite is necessary to the health of the family as a whole and they need to make those realizations stronger than any guilt feelings the demented adult may engender. Something else to try is to make the respite sessions and the time with the sitter into games and fun time. We don't play enough with the demented and they often enjoy it.