On September 1, 2010 Dr. Norman Farb joined the staff at Baycrest as the Women of Baycrest postdoctoral fellow working with Dr. Tiffany Chow in the Frontotemporal Dementia Workgroup. Norman is dedicated to advancing both public understanding of the disorder and developing new techniques for the assessment and care of patients with dementia. The other area of Norman’s work is related to caregivers, who are also critically affected by Frontotemporal Dementia and related disorders.
The other evening, Dr. Farb was the guest speaker at the Women of Baycrest annual Membership Appreciation Reception and Dedication. He spoke about the work he is doing to develop a new model of care to improve quality of life in aging. Here’s some of what we learned from Dr. Norman Farb.
The Canadian Study of Health and Aging estimates that in 2011 there will be 145,000 new cases of dementia in Canada, of which approximately 93,000 will be women. This is not simply a problem for the elderly, but one with broader social implications, as we will all be affected by the need to provide additional care for our elderly,
Worldwide, the elderly support ratio – that is the ratio between working-age people under the age of 65 and those 65 and older stands a 9 working age people to 1 elder, but this ratio will fall to 4:1 in the next 40 years. In Canada the ratio is 5:1 right now, and by 2050 it will be closer to 2:1. What this means is that many of us will have a parent, or relative in need of care in the coming years, with a proportionally smaller workforce to provide this care.
While increased healthcare spending is one way to provide this extra support, realistically, the biggest adjustments will need to be made by family members. The question is not IF you will become a caregiver in your lifetime, it’s a matter of WHEN. Familial caregiving is important and it makes a difference: the absence of a caregiver or having a caregiver who feels overburdened are both major predictors of earlier institutionalization of those with dementia.
Women have particular challenges in caregiving; social factors make women more likely to take on the caregiving role and be more heavily involved in caregiving activities than men. In Canada over 70% of informal caregivers are women, mostly wives, daughters and daughters-in-law. What’s more, 30% of these female informal caregivers are employed, and may also be providing care to their own families at the same time; this places increased stresses on women that are greater than what is experienced by male caregivers. A recent study found that female caregivers had lower scores on 7 out of the 8 scales on a Quality of Life Questionnaire compared to males and an overall decreased quality of life, as a result of more emotional and physical health problems. One major question that we face as a society in coming years, above and beyond how to care for our aging population is: who cares for the caregivers?
Norman is currently researching a new type of training for caregivers known as mindfulness training. Derived from eastern meditation practices, mindfulness training helps a person to develop the capacity to directly experience each moment with a sense of acceptance, opening themselves up to immediate experience rather than turning to a world of judgments, explanations and rumination. In many studies in healthy participants, mindfulness training has been shown to reduce feelings of stress and to promote well-being, and it may also help to protect caregivers from becoming overburdened and sick themselves.
It seems from the research that what the mindfulness training is allowing people to do is to stop worrying about the bigger picture for a moment and to concentrate on what’s actually happening in the room they are in. In the context of caring for an ill or demented family member, this can be a powerful ability. Imagine yourself in the role of caregiver for an elder relative, how would you react? For many of us, there are negative feelings, like we are being forced into a bad situation. But why is this? Could it be that we are all secretly hoping that life will continue happily ever after? Isn’t that the way that fairy tales end? Cinderella does not end up cleaning bed pans.
There is nothing wrong with having ideals and dreams of a pleasant future. These ideals become a benchmark by which to motivate ourselves to do and be more. However, dreams alone do not prepare us to deal with the reality of our aging population and probable roles. To effectively manage the stresses of familial caregiving, a deeper understanding must be cultivated. Dr. Norman Farb believes that learning to put our evaluations and ideals aside and accept our present state is a powerful tool for reducing the stresses of confronting a life more ordinary than fairy tale, of allowing us to appreciate the gift of each moment even if that moment is being spent looking after mom or dad.