Article originally published in the Summer 2019 Alzheimer’s Update

Family members often ask us for tips on how to introduce a formal caregiver to their family member who has dementia. At some point in the dementia disease process, family caregivers will find they need a little help and will hire a formal caregiver. Bringing a new caregiver into the home is important, but often met with some trepidation. Family members with dementia appreciate familiar faces and a routine; they often don’t want you to leave them in the care of a “stranger.” Here are some tips that you might find helpful.

• First, keep your expectations low for the first couple of visits from a formal caregiver. You might even plan on staying in the home as your family member gets used to the idea. You could test out the system by stepping aside for a few moments: spend some time in another room, go out into the garden or go for a short neighborhood walk.
• Second, expect that your family member with dementia won’t remember the “new” caregiver and may be surprised to see him or her on the 3rd, 4th or 20th visit. Alzheimer’s disease affects memory. New information, such a new face, can be difficult to retain.
• Third, help your new caregiver out by setting up a couple of activities you know your family member will like. This could be “Movie Day” with a Kathryn Hepburn movie and popcorn, or a baking day that involves making cookies together. Other ideas include getting a manicure, going on walks, or looking at family photo albums. When your family member is engaged with the new caregiver, quietly leave the house. If you can, avoid explaining where you’re going, when you’ll be back, or why you’re doing this. If it seems appropriate, take the time to thank your family member for spending time with the new caregiver. Let them know they are helping you.
• Finally, and importantly, expect this transition to be difficult for you. After being “on” for so long, it is difficult to let go (even for a couple hours). Thus, it is important for you to plan ahead too. Make those first outings easy, so if you really want to go back, you can. For example, a cup of coffee with an understanding friend, a trip to the library, maybe just lunch in restaurant by yourself. You will get the hang of it, but it does take practice. Know that these breaks are important and that they need to be a priority for you. There will be plenty to do when you get home.

The best way to find someone who can team up with you is to call a local organization. In Portland, the Multnomah County Family Caregiver Support Program offers help and support, 503-988-3646. The Alzheimer’s Association can also be a great source of support, 800-272-3900. Oregon Care Partners offers free caregiver training (on-line and in-person), 1-800-930-6851. 

Follow me, and other caregivers, on Twitter @AllisonLindauer.

Allison Lindauer, Ph.D., N.P. is Assistant professor and director of outreach, recruitment and education for the Layton Aging and Alzheimer’s Disease Center.