When most people hear the word "caregiver," a woman usually comes to mind as the tasks of "caregiving" are often associated with the female gender. However, men are taking on caregiver roles in increasing numbers. About 45% of husbands provide care for wives with dementia while another 30% of sons are also involved in caregiving efforts. It is not uncommon to see brothers, in-laws and grandsons also providing care. However, most male caregivers say they feel unprepared to step into this role.
Bottom Line: Men are more task oriented and seek to solve problems therefore will benefit from practical strategies. Since most caregiving takes place among families and friends, the following strategies can be used to support men in their expanding caregiver roles.
During the initial symptoms of Alzheimer's disease/dementia, men are less likely to notice changes in their wives or to act upon the changes that are seen. Often times it is other family members or friends that bring attention to these changes, thus leading to the diagnosis. In contrast, women are more likely to recognize cognitive changes in their husbands and pursue diagnosis earlier. The difference may be that women have been more proactive in managing the family's health concerns having scheduled and facilitated their children's care in previous years.
Bottom Line: Men will benefit from input from family members and friends about changes they are observing in the person’s memory and thinking abilities. They will also benefit from suggestions toward obtaining a diagnosis from a dementia specialist or your assistance in facilitating this important medical appointment.
In the mild stage of Alzheimer's disease/dementia, men will find themselves assisting in household tasks such as cooking, cleaning, laundry, and shopping. While these tasks may have been very familiar to women, for many men these are new tasks that must be learned. In addition men must balance the affected woman's desire to try to participate in these household chores that can still provide meaning to her. Men should allow their wives/moms to participate as they are able but must reset their own expectations as to how much she is able to assist in a given chore and not be critical if the outcome is less than expected. Most men report that cooking can be one of the hardest chores to master.
Bottom Line: Men will benefit from some simple recipes from family and friends to put into a weekly schedule. A home cooked (and delivered) meal or a gift card is also a welcomed gift from family and friends. Men will also appreciate suggestions for an occasional cleaning service which can be an ideal way to introduce an eventual paid caregiver (companion) into the home.
Moderate Alzheimer's disease/dementia brings added challenges of having to assist with personal care that initially includes grooming tasks (hair and makeup), followed by assistance with dressing and bathing. When incontinence presents, purchasing and assisting with adult briefs adds another layer of complexity. Learning this type of "hands on" care is often much more difficult for male than female caregivers. Visiting the hairdresser weekly and getting a more manageable haircut or perm can assist with daily care. Simplifying make up products will also ease the daily routine while getting some basic hints from the woman's daughter(s), granddaughter(s) or friend(s) on how to apply makeup. Over time, the woman will have more difficulty coordinating clothing and the male caregiver will need to assist in both selection and assistance with dressing. Cleaning out the closet to rid of clothing that does not fit or is no longer needed will help reduce confusion in daily dressing. Putting matching clothing together in the closet or drawer will also allow the person to select clothing a bit more independently. As new clothes are purchased, avoiding buttons and zippers will also ease the dressing process.
Bottom Line: Men will benefit from other women in their lives helping them to learn how to assist the affected person in grooming and dressing. A daughter, granddaughter, or friend can help guide the man in learning these new tasks and assist in ridding the closet and drawers of unneeded clothing and footwear. They can also assist in purchasing new clothing and shoes that are comfortable and easy to put on.
Bathing can be a very frightening and overwhelming experience for many people with dementia, therefore simplifying the process is essential. Purchasing a combined body wash/shampoo and getting rid of other bathing products in the shower will minimize confusion. Some husbands do best in bathing their wives by showering with them. Hiring a “bath aide” through a home care company to provide a weekly bath/shower can be a huge relief. And, a “spit bath” at the sink is often enough to keep the woman clean during the week. It is essential that the bath/shower not be a battle and easing the old habit of a daily bath/shower may need to change if it brings discomfort/distress to the person and consequently the man who may need to give it.
Bottom Line: Men will need suggestions from family and friends if they hear that bathing becomes an issue. Offer practical suggestions to simplify bathing from the frequency of bathing to the types of products used. (Refer to the July 2010 Beacon – Bathing without a Battle for more detailed suggestions.) Research getting a “bath aide” through a home care company and provide that information to the caregiver.
Incontinence is an embarrassing issue that most caregivers avoid talking about; but it is an inevitable part of a progressive dementia. Incontinence is often a primary reason that families will seek residential care. Keeping the person well hydrated and on a toileting routine (for example, toileting every 2 – 3 hours) will minimize incontinence episodes. Male caregivers should encourage as much fluid intake as possible. Since water is rarely the chosen fluid, encouraging juices, non-caffeinated beverages and ice cream shakes throughout the day can often provide enough fluid. Using smaller glasses (4-6 oz.) is generally more successful in getting the person to drink fluid as the larger size glass can be overwhelming. Finding an incontinence product that provides protection and is easy to use will also be important. A pull up brief is likely to be most successful and can be readily found in most grocery stores, pharmacies and big box stores. For nighttime incontinence and minimizing laundry from soiled sheets, disposable or washable underpads will be very beneficial.
Bottom Line: Men will benefit from using very basic strategies of offering frequent and small amounts of fluids throughout the day and taking the person to the toilet every couple of hours. Finding incontinence products that are easy to use and minimize additional laundry will greatly benefit the caregiver.
Men learn to become very competent in their caregiving roles. However, men typically don’t have the same tight social networks as women and are less likely to ask for advice or help from family and friends. Husbands have often relied on their wives to create a social network beyond the home. So, when the wife’s dementia progresses, the husband can become very isolated from both family and friends. While men don’t report the same emotional burden as women, the role of caregiver can take its toll. Men are likely to experience high blood pressure, arthritis and high cholesterol and as many as 25% of men will report depression.
Bottom Line: Men need emotional support as much as women do and can benefit from connecting with other caregivers in an online support group, all male support group, and through helplines, books and websites. Family and friends should encourage their male caregiver to share his feelings and acknowledge to them that stress, anger and frustration are common feelings among caregivers.
Finally, studies show that men don’t get the help they need from family and friends – largely because they don’t ask. Men often start looking for professional help after a trigger event such as a hospitalization, fall or injury whereas women usually look for help after experiencing “burnout.”
Bottom Line: Men need need help in their caregiving roles and aren’t likely to ask. Therefore, family and friends should ask for very practical suggestions as to how they can help. Getting the man to accept help through having the affected woman attend Adult Day Health Care or having a home companion can give the man the time needed to care for his own needs.