Wednesday, 26 July 2017

Care Partner Wednesday--The Crippling Force of Anxiety



We often associate anxiety with dementia, and that's legitimate. There's nothing like an impaired memory to cause fear, especially if everything and everyone is new to you every day--that's scary.

But that's a topic for another day. Elders who don't suffer from cognitive decline, but have an anxiety disorder, have an especially poignant struggle. I am care partner for one such elder, and I've worked with others in the past. They live a special kind of hell, and their care partner's challenge is to bring both peace and well-being into each troubled day.

Each person with an anxiety disorder has triggers. Small events can escalate into a full blown attack in minutes. An unfamiliar environment, some small medical issue (like a rash or a cough) an unfamiliar person giving care--these are just a few examples. An event which seems minuscule to us has huge, unresolvable implications for them.

When an attack occurs, there are several aspects:

  • Speech may become slurred, and the ability to express themselves is hampered by hundreds of conflicting thoughts, running through their brain. Picture a Pacman game, where the little creatures are constantly colliding. 
  • Reasoning is missing. Don't even try to explain or reason with the person, as they aren't listening.
  • Conversation is cyclical. You will go around in circles. Over and over again.
  • They might become short of breath and dizzy. They are definitely a fall risk.
  • There is no sense of humour present. You may be able to joke this same person out of mild anxiety, but it won't work during an attack.
  • Distraction seldom works during a full blown attack. They know something terrible is about to happen, and they won't be distracted.
For the care partner, special grace is needed. Patience, wisdom, love, compassion and a sense of humour. (Keep the sense of humour to yourself during a full-blown attack, but it will help you get through.) 

Sometimes, attacks come out of the blue, and you will shake your head, wondering where that came from. There are times when you can identify triggers and head them off. Sometimes, you just have to go through it with the person, because there is no way around it.

I am facing such a circumstance. On Monday, I have to tell someone with high anxiety that she needs to move from the room she is in, to another one down the hall. It's an unusual circumstance, but it's necessary.  Here are some of the steps I have taken to make this go as smoothly as possible.
  • I will tell her Monday afternoon. The move will happen Tuesday morning. This gives her the respect of knowing ahead of time but minimizes the stress time.
  • I have a whole team of people ready to swoop in as soon as she goes to breakfast. We should be totally finished (including pictures hung) by lunch.
  • Someone is taking her out for the morning after breakfast. Someone else is coming to have lunch with her.
  • Her new room will be set up as closely as possible to the way the old room is set up. The bed she is used to is being moved.
  • All staff are aware and are supportive.
  • Staffing assignments are being changed so that she will have familiar staff in her new room.
  • She has an (as needed) order for anti-anxiety medication, and it will be needed those few days.
With all this preparation, will it be seamless, and without anxiety? No, it won't. But we've made a plan, and it will be as good as it can. In a few days, we will be over this challenge, and on to the next.

Living with chronic anxiety is a burden. Care partners need to offer both strength and grace, through a filter of wisdom. 

And don't forget the sense of humour!


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