Alzheimer’s / Counselling

Getting help from a Counselor or Therapist can make a big difference. One of the Alzheimer’s Society’s information sheets describes counseling as: giving people the chance to talk in confidence to a trained professional counselor about problems or issues that are causing them concern. This can be very helpful and important for patients, their carers, and for former carers. There are many different types of counseling available.

Counseling consists of an agreed number of regular sessions between a counselor or therapist and the person seeking support. The counselor listens to the person’s concerns in a non-judgmental and supportive manner. Together, the counselor and the client try to find ways for the client to cope and/or feel better about themselves and their situation. This may result in a more satisfying and manageable life.

It is important that people work with a counselor whose style and way of working they feel comfortable with. Qualified professional counseling is expected to be absolutely confidential. No one else will know what you talk about. Some of the issues that the client might bring to the session may be distressing; this is normal. Sharing these feelings and thoughts in a
supportive, safe and confidential setting is often helpful and can be life changing.

Counseling can increase feelings of self-worth, well-being and capability, and help ease feelings of depression, anxiety, loss of control and sleeplessness.

Living with dementia can raise many difficult feelings and thoughts as the person attempts to make sense of what is happening to them and how their life is changing. Some people with dementia feel angry, confused, frightened or anxious. Their family and friends may be tied up in how they themselves are feeling, and it may be difficult for the person with dementia to discuss their feelings with them frankly. Counseling might provide the person with dementia with the opportunity to speak honestly about their feelings and work out ways to live with their condition. Traditional counseling expects clients to have full use of their cognitive abilities. However, experience has shown that people with significant changes in their cognition (memory, speech, thought processes) still respond well to aspects of counseling.

Living with dementia as a carer or a concerned relative, friend, neighbour or careworker can feel overwhelming and lonely. Carers often have very little time to themselves and it is easy to get run down and exhausted. Many carers experience feelings of sadness, grief, guilt or anger; counseling may help them to explore these feelings, as well as providing extra support outside their network of friends and family.

A former carer or careworker may feel lost or sad when the person they have cared for moves away or dies. After the caring relationship ends it may be difficult to move on, to recover from the loss and to accept a new and different role. This is a normal reaction. Counseling may help a former carer to accept the past and look ahead to the future.

There are many ways to find a counselor. A recommendation from someone else who has had counseling can be very helpful. The GP should also be able to provide details of local counselors and there may even be a counseling service run through the GP’s clinic. The social services department or local Citizens Advice Bureau may also have information – the number will be in the phone book. Most private counseling services operate a sliding scale for fees. Counseling services accessed through NHS referrals are usually free of charge. The British Association for Counseling and Psychotherapy (BACP) can provide more information about counseling and local counseling services.

The Alzheimer’s Society lists:

Physiotherapists can advise on exercise for people at all stages of dementia. They can also advise carers on safe ways of helping someone to move. Home visits can be arranged. The GP or consultant can refer you to the community physiotherapy service or the hospital physiotherapy department. Some physiotherapists are in private practice. Look for the letters MCSP and/or SRP after their name to ensure that they are professionally qualified (see The Chartered Society of Physiotherapists under Useful Organisations).

Audiologists can check for hearing problems and can fit a hearing aid, if appropriate. Once fitted, hearing aids should be checked regularly. Hearing tests, equipment and equipment checks are free on the NHS. Ask the GP for a referral to the nearest NHS hearing centre, preferably while the dementia is at an early stage.

Dentist’s advice should be obtained as soon as dementia is diagnosed. If any major treatment is needed it should be carried out as soon as possible, as dental treatment may become more difficult as dementia progresses. Regular dental care is important to ensure that teeth and gums are healthy and that dentures, if worn, are comfortable. If you are caring for someone in the later stages of dementia you may need advice on how to clean their teeth. Ask the dentist or dental hygienist.

If the person with dementia already has a dentist whom they know and trust, they should continue to see that dentist for as long as possible. Your dentist may be able to arrange home visits, if they are needed. If not, contact your community dental service (CDS), which can cater for people who need treatment at home. NHS home visits are free but the normal charges for treatment may apply, depending on income.

Details of local NHS dentists and your local CDS can be obtained from your local primary care trust (address in the phone book) or ask at your doctor’s surgery. If you wish to consult a dentist privately check first on fees and the cost of home visits. Many NHS dental practices also do private work. It is often a good idea to have a recommendation from a friend or neighbour.

Optometrists are important, since problems with sight can add to confusion. Sight should be regularly checked by an optometrist, who will also examine the eyes for signs of glaucoma, cataract and other eye and medical conditions. If you do not have an optometrist, ask your GP or a friend or neighbour for a recommendation. You will need someone who understands what examining someone with dementia may involve. Some optometrists will carry out a home visit. Ask about fees. People over 60 are entitled to a free NHS eye examination and some people under 60 with dementia may also be entitled to a free NHS eye examination.

Speech and Language Therapists can advise someone with dementia and their carer on ways of communicating more effectively and on swallowing difficulties. Your GP may be able to refer you or you can refer yourself. For details of your local speech and language therapy department, contact the Royal College of Speech and Language Therapists.

Chartered Clinical Psychologists assess memory, learning abilities and other skills and offer support. They often work with consultants in memory clinics as part of a team.

Continence Advisers advise on problems associated with incontinence. They can also give information on useful equipment ranging from commodes to incontinence pads. Your GP may refer you or you can get in touch direct.
To find the address of your local continence adviser contact The Continence Foundation.

Dietitians – If you have any concerns about a person with dementia eating or drinking, help is available. A dietitian can provide advice and guidance about food, nutrition and issues such as a poor appetite, weight loss, weight gain, vitamins and food supplements. A professionally qualified dietitian will have SRD after their name. Your GP or consultant can arrange for a referral to a dietitian. Some dietitians may be able to offer a domiciliary visit to people who are housebound; others may be based at a local health centre, GP practice or hospital.

Occupational Therapists (OTS) – OTs can advise on adaptations and equipment and on ways of maintaining independence for as long as possible. Some OTs work for the health service and some for social services. Ask your GP, consultant or social services if you think an OT might be helpful.
Some OTs work privately. To find an OT privately contact Occupational Therapists Independent Practice.

Social Workers have specific professional training and qualifications. They may be involved in assessing needs for services and in planning, co-ordinating and advising on services. They can also offer support if you need to talk things through. Social workers are based in a wide variety of settings. These include social services departments, hospitals and care homes. To talk to a social worker, contact your social services department (the address will be in the phone book under the name of your local authority) or ask a nurse at your GP practice or hospital.

Social Care Workers work in a wide variety of settings and are known by a variety of names. Some work as home care workers or care attendants in the person’s home or as residential care workers in care homes, for example. They may help with personal care such as getting the person up, washed and dressed, changing bedding and emptying commodes, doing laundry, supervising meals to make sure the person eats properly and putting them to bed at night.

The brief information above about these practitioners is derived primarily from the Alzheimer’s Society website. For more complete information, see the Alzheimer Society’s information sheets or contact the Society. We also add strong recommendations that music therapy and physical exercise have proven to be important and helpful. Be sure to click on our For Alzheimer’s Help list, Complementary Techniques and Therapies Guide (and NB music therapy) and our HIT list for a wide range of further resources and possibilities.