INTRODUCTION

In Spain at present there are nearly 600.000 patients of Alzheimer's disease, being the first one between the illnesses neurodegenerativas, as well as the first cause of dementia in the aged population. 65 % of the relatives who take care straight of the patient will suffer substantial changes in his lives and an important decrease of his physical or psychic health, going so far as 20 % to develop an intense picture known as "Burn-Out" or of the careful - burned one.

The principal minder of a patient of Alzheimer's disease is usually in Spain a woman, daughters or spouse of the patient, who acts generally alone since rare is the family in which his members are employed really equitably "at team" at the time of taking care of the patient. This principal minder is assuming gradually most of the tasks of taking care, even to go so far as not to make really thing almost different in his personal life but to devote itself 24 hours a day to this work.

BURN-OUT OR SYNDROME OF THE BURNED MINDER

The syndrome of the burned minder or burn-out was described by it firstly in the United States in 1974. It consists of a deep emotional and physical wear that there experiences the person who lives together and takes care of an incurable chronic patient such as the Alzheimer's disease patient. The minder who can suffer it is that that goes so far as to dedicate almost all his time (even stopping working to take care of him), generally alone (although there are other relatives who occur rarely "to wash their hands" and to be supported in the periphery), during already many years and with passive and inadequate problem solving strategies.

IT HELPS FOR THE MINDER

A series of useful proposals can be done at the time of developing institutional programs "to take care of the minder":

1. To accept that these depletion reactions are frequent and even and foreseeable in a minder. There are normal reactions to an "extreme" situation, but that need support.
2. Not to forget himself, always putting itself secondly. The "entire autosacrifice" has no sense.
3. To ask for personal help on having detected these signs, not to conceal them for fear of assuming that "one is at the edge of his forces" not neither through the fault of being a super-minder.
4. Not to be afraid to come to a professional (psychiatrist or psychologist) and to groups of self-help (SCALE) of associations of affected by the illness of Alzheimer's disease that they turn out to be very effective.
5. To learn skills of psychophysical relaxation, distractiva visualization, Yoga, etc.
6. To request information and formation adapted on medical aspects of the illness (future evolution, forecast of complications, medication) and practical knowledge to face the such derivative problems like nutrition, hygiene, adaptation of the hearth, mobilizations of the patient, etc. All this increases the feeling of control and of personal efficacy.
7. Real, short-term and feasible targets are marked in the tasks with taking care. Not to support unreal expectations ("The patient is not going to deteriorate any more than it is"), not either omnipotent ideas on one ("I Am going to solve all the problems only").
8. To be capable of delegating tasks in other relatives or employed personnel (sanitary or of the hearth). Not to be considered essential.
9. To stay automotivated long-term, car to be reinforced in the successes, being congratulated himself on everything good that it is doing.
10. Not to be fixed only in the shortcomings and mistakes that are had.
11. To take care especially of the proper rests and the proper feeding: to stop 10 minutes every two hours, to sleep the sufficient hours and to support a suitable diet.
12. To take also every day one hour to realize the proper matters. Also to allow him a fully deserved daily or weekly rest, out of the direct contact with the patient.
13. If it is possible, to realize physical exercise every day, since it eliminates corporal toxins and clears the mind.
14. To avoid the isolation: to bind to maintain the contact with friends and other relatives. To go out of the house with other persons, not to remain "cloistered". The warm affective ties muffle the stress.
15. To be able to put limit on the excessive demands of the patient; it is necessary to be able to say NOT, without feeling guilty for it (asertivitad).
16. To express openly to others the frustrations, fears or proper resentments, is an always beneficial emotional leakage.
17. To plan the activities of the week and of the day. To establish tasks priorities, differentiating the urgent thing of the important thing. To decide what things it is not going to be able to realize with enough probability. The absence of time is one of the first causes of burden.
18. To promote the independence of the patient. The minder must not realize what the patient could do for himself, although it makes it slow or bad.
19. To use day Centers, Residences of temporary breather, or employed Personnel of home assistance.

TO SEE ALSO

• What is the Alzheimer's disease?
• Treatment of the Alzheimer's disease
• Demencias
• Topics of Psychology

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