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Frau Hofer

Mrs. Hofer, 70 years old at the time of the interview, talks retrospectively about her experience as a family caregiver. The interview took place five years after the death of her husband, who suffered from mixed dementia (Alzheimer's, vascular dementia, frontotemporal dementia) and died at the age of 65. While caring for her husband, she was also employed fulltime. Mrs. Hofer has no children. She lives in the German-speaking region of Switzerland. The couple met shortly before her husband developed dementia. They married and her husband moved from Germany to live with Mrs. Hofer in Switzerland. The first symptoms appeared seven years before the diagnosis, when her husband was 60 years old. The intensive care period started one year after the diagnosis when her husband could no longer be alone during the day and Mrs. Hofer had to change the care arrangement several times because her husband left the day homes and behaved aggressively. Until his death, he was cared for partly at home and partly in a nursing home. The fact that Mrs. Hofer's employer showed understanding for the care situation and that she was able to change her working hours and location were very helpful.

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Mrs. Hofer created an advance directive together with her husband.

Mrs. Hofer created an advance directive together with her husband. At that time, he was still able to understand the contents as well as sign the document himself. When he could no longer write, she applied for guardianship with the municipality, which supported her.

TRANSCRIPT

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Other experiences by Frau Hofer

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Frau Hofer

Mrs. Hofer, 70 years old at the time of the interview, talks retrospectively about her experience as a family caregiver. The interview took place five years after the death of her husband, who suffered from mixed dementia (Alzheimer's, vascular dementia, frontotemporal dementia) and died at the age of 65. While caring for her husband, she was also employed fulltime. Mrs. Hofer has no children. She lives in the German-speaking region of Switzerland. The couple met shortly before her husband developed dementia. They married and her husband moved from Germany to live with Mrs. Hofer in Switzerland. The first symptoms appeared seven years before the diagnosis, when her husband was 60 years old. The intensive care period started one year after the diagnosis when her husband could no longer be alone during the day and Mrs. Hofer had to change the care arrangement several times because her husband left the day homes and behaved aggressively. Until his death, he was cared for partly at home and partly in a nursing home. The fact that Mrs. Hofer's employer showed understanding for the care situation and that she was able to change her working hours and location were very helpful.

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Frau Hofer

According to Mrs. Hofer, it was too late for her husband to receive effective drug therapy.

According to Mrs. Hofer, it was too late for her husband to receive effective drug therapy. The diagnosis was made late. In addition to ginkgo, he took antidepressants.

Therapeutic approaches

Dementia

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Frau Hofer

For Mrs. Hofer, maintaining her job allowed for continuity in her life and a counterpoint to caregiving.

For Mrs. Hofer, maintaining her job allowed for continuity in her life and a counterpoint to caregiving.

Processes of adaptation

Dementia

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Frau Hofer

When her husband lost his speech, Mrs. Hofer also lost confidence in being able to understand him.

When her husband lost his speech, Mrs. Hofer also lost confidence in being able to understand him. At times, she could only guess what he meant.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

Mrs. Hofer took antidepressants for relaxation and peaceful sleep while caring for her husband, who had dementia.

Mrs. Hofer, who worked full time while caring for her husband, had long and stressful days. She took antidepressants for relaxation and a peaceful sleep.

Processes of adaptation

Dementia

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Frau Hofer

Mrs. Hofer was able to count on the understanding of her employer.

Mrs. Hofers husband would call her very often while she was working at the store. Fortunately, she could count on her employer to be understanding. In emergency situations, she could interrupt her work and go home. She was able to shift her work home so that she could stay with her husband.

What helps? - Caregivers' perspective

Dementia

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Frau Hofer

Mrs. Hofer still feels drained today.

After the death of her husband, Mrs. Hofer avoided committing to anything and volunteering. She still feels exhausted today.

Processes of adaptation

Dementia

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Frau Hofer

Had she not had an understanding supervisor, she would have had to retire early, Mrs. Hofer says.

Had she not had an understanding supervisor, she would have had to retire early, Mrs. Hofer says.

What helps? - Caregivers' perspective

Dementia

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Frau Hofer

Mrs. Hofer had to repeatedly resolve problems caused by her husband's difficult behavior in public.

Mrs. Hofer had to repeatedly resolve problems caused by her husband's difficult behavior in public. When she went shopping, she carried a small card that noted his illness, which she discreetly held out to the salespeople in the store.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

Mrs. Hofer lost her husband as a conversation partner due to dementia.

Mrs. Hofer lost her husband as a conversation partner due to dementia. She has been alone with her wishes, feelings and tasks ever since.

Processes of adaptation

Dementia

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Frau Hofer

The landlady of the hotel where Mrs. Hofer and her husband were vacationing became more understanding.

The landlady of the hotel where Mrs. Hofer and her husband were vacationing became more understanding when Mrs. Hofer informed her of Mr. Hofer’s illness.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

The sedation had noticeably weakened her husband, Mrs. Hofer says.

Mrs. Hofer's husband was medicated several times at the psychiatric hospital. The sedation had noticeably weakened her husband. Her husband had lost his orientation, no longer knew how to eat, and in the end he could hardly walk.

Therapeutic approaches

Dementia

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Frau Hofer

The authorities did not recognise her husband's failures as a possible illness, Mrs. Hofer says.

After the death of her husband, Mrs. Hofer contacted the Regional Employment Agency (RAV) to make them aware of dementia in younger persons. She expressed criticism of the discrediting treatment of her husband by the representatives of the authorities, who did not explain his failures as a possible illness, but attributed them to his person.

What is dementia?

Dementia

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Frau Hofer

Mrs. Hofer describes a moment when her husband was lucid in which he showed her his love. She, too, reminds herself of their relationship as a couple, which was always loving.

Mrs. Hofer describes a moment when her husband was lucid in which he showed her his love. She, too, reminds herself of their relationship as a couple, which was always loving.

Processes of adaptation

Dementia

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Frau Hofer

Mrs. Hofer encourages family members to get help because people reach a limit when it comes to caring for their loved one with dementia, and the quality of care suffers as a result.

Mrs. Hofer encourages family members to get help because people reach a limit when it comes to caring for their loved one with dementia, and the quality of care suffers as a result.

What helps? - Caregivers' perspective

Dementia

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Frau Hofer

Mrs. Hofer says that her husband's living will was a guideline for her because it outlined his preferences.

Mrs. Hofer believes that her husband's living will was a guideline for her because it outlined his preferences.

Advance care planning

Dementia

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Frau Hofer

Health professionals should provide complete information about an intervention, finding, or procedure, and not take for granted that family members know, Mrs. Hofer says.

Health professionals should provide complete information about an intervention, finding, or procedure rather than taking it for granted that family members know, Mrs. Hofer says.

What helps? - Caregivers' perspective

Dementia

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Frau Hofer

Her profession has replaced the lack of social recognition of care work at home, says Mrs. Hofer.

Mrs. Hofer says her job compensated for the lack of social recognition of home care work, which is why she rejected her family doctor's suggestion that she take sick leave to stay home.

What is dementia?

Dementia

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Frau Hofer

Mrs. Hofer created an advance directive together with her husband.

Mrs. Hofer created an advance directive together with her husband. At that time, he was still able to understand the contents as well as sign the document himself. When he could no longer write, she applied for guardianship with the municipality, which supported her.

Advance care planning

Dementia

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Frau Hofer

The disability pension only began to apply to Mrs. Hofer's husband after his dementia diagnosis. Before that, he had to accept financial disadvantages because he was receiving unemployment benefits.

Mrs. Hofer's husband's disability pension only began to apply after he was diagnosed with dementia. Before that, he had to accept financial disadvantages because the dementia remained undetected. When he lost his job due to difficulties at work, he was officially looking for work and received unemployment benefits.

Costs of care

Dementia

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Frau Hofer

Not all the nurses handle difficult patients equally as well, which is why support from relatives is needed, concludes Mrs. Hofer.

Not all the nurses handle difficult patients equally as well, concludes Mrs. Hofer. It took Mrs. Hofer's support to prevent escalations between her husband and the Spitex employee providing him with dementia care.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

Mrs. Hofer would have wanted to be informed about her husband's pneumonia by the nursing home even so she was taking time off from caring.

Mrs. Hofer would have wanted to have been informed about her husband's pneumonia by the nursing home even so she was taking time off from caring. Since she was not told, she feels she was denied the opportunity to make the decision to interrupt the leave and return to caring for her husband.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

Mrs. Hofer describes the exhausting care that her husband required in the last months before his death.

Mrs. Hofer's husband was also cared for by her at home during the last months before his death. Mrs. Hofer tells how badly he was feeling at that time and that she was reaching her limits in terms of strength.

At home or in a nursing home?

Dementia

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Frau Hofer

In Mrs. Hofer's case, there was a heated confrontation with the psychiatric nursing staff.

Because Mrs. Hofer lacked important information about visitation rights and because she assessed an incident between her husband and a nurse in the psychiatric ward quite differently than the institution did, a heated dispute arose between her and the psychiatric nursing staff.

Four levels of communication of the caregivers

Dementia

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Frau Hofer

The tragedy of dementia is losing oneself, says Mrs. Hofer.

The tragedy of dementia is losing oneself, says Mrs. Hofer. Her husband noticed how he lost his ability to act, which gnawed away at his self-worth.

Processes of adaptation

Dementia

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Frau Hofer

Mrs. Hofer feels the death of her husband as a relief. Both had been released from suffering.

Mrs. Hofer feels the death of her husband as a relief. Both had been released from suffering. She cannot estimate how much her husband perceived of his illness.

Processes of adaptation

Dementia

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Frau Hofer

Over time, Mrs. Hofer noticed that her husband was stressed at home alone. A new care arrangement presented itself.

While Mrs. Hofer worked, her husband initially spent the day at home alone. Over time, Mrs. Hofer noticed that he was stressed out alone. A new care arrangement was imposing itself. Because the care hours at the day home were incompatible with her work hours, she had to organize additional drop-off and pick-up, as well as early evening care, in addition to the day structure.

At home or in a nursing home?

Dementia

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Frau Hofer

Mrs. Hofer had to reorganize the care setting for her husband several times.

Mrs. Hofer had to reorganize the care setting several times. One year after her husband was cared for in a day structure during the day, she had to look for a new day structure for him because the home could not continue to care for him because he was running away and behaving aggressively.

At home or in a nursing home?

Dementia

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