Support for Alzheimer's Caregivers

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Running Head: HEALING TOGETHER
Healing Together: Support for Family Members and Caregivers of Alzheimer’s Patients
Maggie Miller
University of Georgia

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HEALING TOGETHER
Healing Together: Support for Family Members and Caregiver of Alzheimer’s Patient
Research Paper
Topic Overview
Dementia is a chronic disease that, according to the Alzheimer’s Association (2018),
affects an estimated 5.5 million people in the United States over the age of 65 years old. It is the
decline in one’s mental ability. Dementia is an umbrella term for the symptoms that are
associated with memory loss. Of all the reported cases of Dementia, 60-80% of the cases are
patients with Alzheimer’s (Correa, Giacobbo, Vedovelli, et al, 2016, p. 2). Dementia and
Alzheimer’s takes a major toll not only on the person diagnosed with the disease, but also on the
family members and caregivers of the patient.
It is difficult to witness a love one’s mind deteriorate and know there is nothing to do to
stop the progression. Stated in Mundia (2001), people who are diagnosed with Dementia or
Alzheimer’s progress in different ways and at different times. The duration of each stage of the
disease is unknown, so it is hard to predict the timeline of the disease from when symptoms
begin to show and the effects of what will come next. The stress this disease has on a family
member or caregiver can be detrimental to one’s health. A program designed to inform the
family members and caregivers of the patient about the effects the disease not only has on the
patient, but also on family members and caregivers can be beneficial when it comes to the
emotional health of everyone involved.
Review of Literature
Risk Factors

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Dementia/Alzheimer’s is a very gradual progressing disease. To watch someone go
through this decline is heartbreaking. According to Eifert (2017, p. 217-218), caring for a person
with Dementia or Alzheimer’s can be very stressful and have a negative impact on one’s health,
physically and emotionally. Caregivers of patients with this disease usually experience a great
deal of stress and turmoil as the patient’s mind withers away. This is known as caregiver burden.
“Caregiver burden can be thought of as a negative reaction to unchecked stress related to
caregiving.” This type of stress can lead to depression and can also affect one’s physical health
as well.
The disease not only impairs a person’s mind, it also causes physical disabilities and
behavior problems. As the disease progresses, a person will lose the ability to dress themselves,
swallow and may become hard to deal with. The rate at which the disease will progress and very
uncertain. “These progressive and unpredictable disorders are often difficult for caregivers to
manage and can cause stress, frustration, and burden” (Yu, Wang, He, et al, 2015, p. 9). It is hard
for a caregiver of an Alzheimer’s patient to prepare what kind of care a patient need because the
disease is so unpredictable.
Although some families who have a member diagnosed with the disease hire caregivers
to assist the patient, many families do the caregiving themselves. For older individuals with the
disease, this could be their spouse it he or she is still alive and able to care for them, or it could
be an adult son or daughter. Correa, Giacobbo, Veldovelli, et al (2016, p. 2), stated that for elder
spouses who do the caring, the effects of the caregiving can lead to serious health issues. The
stress put on the elder caregivers can lead to cognitive declines and dementia. Elder caregivers
have a higher chance of losing their memory because of the stress caused by the care they give to
a person with dementia.

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Studies have shown that many elder men are now caring for their partner with
Alzheimer’s. Now, men and women share roles in the family system, but studies still have shown
that even though men have taken on the role as being a caregiver, they still are shown to be less
experienced than women. When men have to assume the role of the caregiver for their partner it
can be very taxing to their overall emotional health. “Men aged 65 and over are a vulnerable
group of caregivers as they have been dependent on their wives for emotional support”
(Simpson, Stansbury, Wilks, et al, 2018, p. 304). Because their wives are not mentally there
anymore, they are no longer able to provide the emotional support their husbands need.
Especially during a time like this, not just men, but anyone would need a tremendous amount of
emotional support.
Protective Factors
There are many different coping strategies that people use to get through a difficult
situation. For example, religion is a big coping strategy people use. “Religious coping has been
found to mediate and moderate the relationship between stress and health” (Eifert, 2017, p. 221).
Family members and caregivers could benefit tremendously if there were programs that offered
religious support. This support could be beneficially for the family members and caregivers’
health and overall well-being.
Religion is also a big factor in resiliency. According to Wilks, Spurlock, Brown, et al,
(2018), “spirituality is recognized as an essential factor or resilience, providing families with the
ability to overcome stressful situations, including Alzheimer’s disease.” Resiliency is important
to have when dealing with diseases. Programs that promote resilience could be beneficial to
family members and caregivers in promoting a healthier lifestyle.

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One of the big stressors that comes from caring for a patient with Dementia or
Alzheimer’s is the fact that the disease progresses at a different rate for everyone. Because of
this, it is hard to prepare a caregiver or a family member for what to expect and when to expect
the decline. “It is necessary to slow the progression of dementia to provide effective support to
caregivers, to enhance caregivers’ feelings of positive emotions, and to establish specialized care
institutions for patients with Dementia, so as to reduce caregiver burden” (Yu, Wang, He, 2015,
p. 10). A program dedicated to giving support to caregivers can be helpful in reducing the burden
that comes with caring for a patient with Dementia or Alzheimer’s.
The reason many support groups are so successful is because they are bringing people
together who are dealing with the same issue. Dementia and Alzheimer’s have different effects
on people, but by talking to people who are going through a similar situation and feeling the
same types of emotions can help people feel better about the situation. “Support groups promote
supportive communication and interactions by bringing caregivers together who are experiencing
similar challenges, barriers as well as success” (Simpson, Stansbury, Wilks, et al, 2018, p. 307).
Support groups can lift the heavy burden the disease puts on family members and caregivers, and
this can reduce the stress and promote better emotional health.
Implications
Support programs that provide guidance and supportive communication for family
members and caregivers of Dementia and Alzheimer’s patients can be beneficial for the
emotional and physical health of the adult family members and caregivers. One, because religion
and spirituality were such an important factor in coping with the stress of the disease, the
program should be held at a church. There should be a preacher who attends the program to give

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proper guidance and support for family members and caregivers who rely heavily on their
religion.
Two, the program should be held one day every month so that support can be given
through-out the whole progression of the disease. Because the disease progresses at different
times for each patient, it would be most beneficial to offer the program at least once a month.
Offering the program once a month can also help family members and caregivers of Dementia
and Alzheimer’s patients build a support system with people who are experiencing a similar
situation they are.
Three, lessons along with different breakout sessions should be provided to discuss issues
one has and receive supportive communication from people who are going through similar
situations. People reported that supportive communication was very helpful. Sharing about one’s
experience can be beneficial to the family members and caregivers who attend the program. This
type of support can help lift the burden that is imposed on family members and caregivers of
Dementia and Alzheimer’s patients.
Because the patient will eventually get to the point where they need assistance and doing
day to day activities, such as bathing and dressing themselves, a certified nurse should present at
the program every now and then so family members and caregivers understand the
responsibilities the job for caring for the patient entails at this stage of the disease.
Conclusion
Dementia and Alzheimer’s not only have enormous health impacts on the person
diagnosed with the disease, but also people who care and are close to the patient. A program
designed to give support for family members and caregivers of the patient could be beneficial to
the emotional well-being of the family members and caregivers. This program would foster

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supportive communication and religious and spiritual beliefs that the family members and
caregivers might have.

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Program Objectives
 Over the course of the program, 75% of the members will gain an understanding of the
idea and purpose of the program, measured by a survey.
 Over the course of the program, 75% of the members will feel comfortable with sharing
thoughts, concerns, and their emotions about their experience with their loved one who is
diagnosed with Alzheimer’s with the staff and other members of the group, measured by a
survey.
 75% of group members recognize the effects of Alzheimer’s has not only on the person
diagnosed with the disease, but also the effects the disease has on caregivers and loved
ones.
 75% of group members will begin to build support systems with other members in their
small groups and will decide for carrying out this support; even on days that the program
is not scheduled. Members will post on the Facebook when they meet with their small
group and the overall theme discussed during the meeting.
 In 6 months, 75% of members will meet regularly with their small groups to discuss issues
and concerns and provide support; measured by a survey.
 Throughout the session, 75% of the members of the group will discover what coping
strategies work best for them and how to utilize these coping strategies to deal with the
effects of Alzheimer’s.
 75% of the members will meet up or call another member of their small group once a week
to provide support to one another. The group members will document who they talked to
and what they discussed on the group Facebook page.
 In 6 months, 75% of the group members will feel confident in confiding with their small
group members; measured by a survey.
 75% of the members will learn how to communicate with their loved one/patient in an
empathetic way about their disease.
 75% of the members will pick a day each week to sit down with their loved one/patient and
remind their loved one/patient about memories, family members, and friends.
 In 6 months, 75% of the members will be comfortable with discussing the stages and effects
of the disease with their loved one/patient without feeling any guilt; measured by a survey.

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 75% of members will understand the effects that Alzheimer’s has on not only the patient,
but other people who might care and love the patient.
 75% of members will meet up with one another, at least once a week, to discuss feelings,
emotions, and experiences and give support. Members will post on the group Facebook
page to document their meeting times and the overall theme discussed in the small
groups.
 Measured by a survey, in 6 months, 75% of members will have built peer networks and
will have and understanding of the disease and use coping skills to deal with the stressors
of the disease.

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Logic Model
1.Healing Togethermembers will feel welcomed and will construct a schedule for meeting times with small group members.
2.Members of the group will learn and be able to recognize the different stages of Alzheimer’s.
3.Members of the group will learn about different forms of coping strategies.
4.Members will be able to use the knowledge gained from the program to bettercommunicate with their loved one/patient diagnosed with Alzheimer’s.
5.Members will be able to comprehensively identify the progression of Alzheimer’s and take away valuable coping skills from this program.
Imputs
Outputs
Outcomes -- Impact
Activities Participation Short Medium Long

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 Trained nurses
 Trained Staff
 Minister
 Funding
 Food
 Information
packets
 Paper for
handouts
 Church or
community
center
 Time
 Break out into
small group
sessions (support
groups)
 Individual/
family
counseling
 Group sessions
when nurses
explain
what/how
Alzheimer’s
progresses and
coping strategies
 Caregivers-
workshop of how
to betterassess
the family
 Family- break
out support
sessions
 Over the course ofthe
program, 75% of the
members will gain an
understandingof the
idea and purpose of the
program, measuredby a
survey.
 75% of group members
recognize the effects of
Alzheimer’s has not
only on the person
diagnosedwith the
disease, but also the
effects the disease has
on caregivers andloved
ones.
 Throughout the session,
75% of the members of
the group will discover
what copingstrategies
work best for themand
howto utilize these
copingstrategies todeal
with the effects of
Alzheimer’s.
 75% of the members
will learn howto
communicatewith their
lovedone/patient in an
empathetic way about
their disease.
 75% of members will
understandthe effects
that Alzheimer’s has on
not onlythe patient,but
other people who might
care andlove the
patient.
 Over the course of
the program, 75% of
the members will
feel comfortable
with sharing
thoughts,concerns,
andtheir emotions
about their
experience with
their lovedone who
is diagnosedwith
Alzheimer’s with
the staff andother
members of the
group, measuredby
a survey.
 75% of group
members will begin
to build support
systems with other
members in their
small groups and
will decide for
carryingout this
support; even on
days that the
program is not
scheduled. Members
will post on the
Facebook when they
meet with their
small group andthe
overall theme
discussed duringthe
meeting.
will meet up or call
another member of
their small group
once a week to
provide support to
 In 6 months, 75%
of members will
meet regularly
with their small
groups to discuss
issues and
concerns and
provide support;
measuredby a
survey.
 In 6 months,75%
of the group
members will feel
confident in
confidingwith
their small group
members;
measuredby a
survey.
 In 6 months, 75%
of the members
will be
comfortable with
discussing the
stages andeffects
of the disease with
their loved
one/patient
without feeling
any guilt;
measuredby a
survey
 Measuredby a
survey, in 6
months, 75% of
members will have
built peer
networks andwill
have and
understandingof

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one another. The
group members will
document who they
talkedto andwhat
they discussedon
the group Facebook
page.
will pick a day each
week to sit down
with their loved
one/patient and
remindtheirloved
one/patient about
memories, family
members, and
friends.
 75% of members
will meet up with
one another, at least
once a week, to
discuss feelings,
emotions, and
experiences and
give support.
Members will post
on the group
Facebook page to
document their
meetingtimes and
the overall theme
discussed in the
small groups.
the disease anduse
copingskills to
deal with the
stressors of the
disease.
Assumptions External Factors
 Participants will attend the program  Transportation- not being able to get to the meeting

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 Participants will be involved in the activities
 Staff and nurses will be willing to provide their knowledge
 People will leave with more knowledge about the disease and
accomplish the listed goals and objectives
 Time conflict
 Family members and friends encouraging family
members/caregivers to seek help/support

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Instructional Guide
Welcome Session
Goal: Healing Together members will feel welcomed and will construct a schedule for
meeting times with small group members.
Objectives:
 Over the course of the program, 75% of the members will gain an understanding of the
idea and purpose of the program, measured by a survey.
 Over the course of the program, 75% of the members will feel comfortable with sharing
thoughts, concerns, and their emotions about their experience with their loved one who is
diagnosed with Alzheimer’s with the staff and other members of the group, measured by
a survey.
Description of the Program:
 This is a program designed to educate family members and caregivers of Alzheimer’s
patients on the different stages of the disease. This program is also intended to build peer
relationships for support. Presentations will be given by nurses and staff members about
Alzheimer’s and its effects on both the patient, loved ones, and caregivers. There will
also be times during each session where the participants of the program will break into
small groups to build peer networks and to discuss concerns and feelings they might
have. This program is geared towards people of Christianity, and there will be a minister
available at each session for members to talk to. “Religious coping has been found to
mediate and moderate the relationship between stress and health” (Eifert, 2017, p. 221).
This support can be beneficially for the family members and caregivers’ health and
overall well-being.
Vision:
 To provide family members and caregivers of Alzheimer’s patients education of the
disease, a peer network for support, and a safe environment for emotional disclosure and
support.
Meeting Times:
 Time: Every other Sunday of the month from 3:00p.m. to 5:00p.m.
 Where: At a local Church’s social hall
 Walk-in Hour after the session for one on one time with a staff member or nurse:
5:00p.m. to 6:00p.m.

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Materials Needed
 Paper
 Pencils/Pens
 Computers
 Bibles
 Food
 Water
 Cups
 Paper plates
 Napkins
 Chairs
 Tables
 Survey for time availability to meet with members of small group:
1. What are your work hours during the week?
2. Is it more convenient for you to meet early in the day, middle
of the day, or late in the day? Please list specific times.
3. Where is it convenient for you to meet? At the church or
somewhere else in town? If somewhere else, please list where.
4. What do you want to get out of the program most? More
education about Alzheimer’s, emotional support, social
outlets?
Ground Rules
 We want to provide a safe and open environment where everyone feels welcomed.
 Stories and experiences are to be kept confidential and should not be discussed with
people outside of the program.
Preparation of Background Material:

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 Dementia is a chronic disease that, according to the Alzheimer’s Association (2018),
affects an estimated 5.5 million people in the United States over the age of 65 years old.
Dementia is the decline in one’s mental ability. Dementia is an umbrella term for the
symptoms that are associated with memory loss. Of all the reported cases of Dementia,
60-80% of the cases are patients with Alzheimer’s (Correa, Giacobbo, Vedovelli, et al,
2016, p. 2). Dementia and Alzheimer’s takes a major toll not only on the person
diagnosed with the disease, but also on the family members and caregivers of the patient.
Facilitators of the Program:
 Family Life Educators
 Nurses from assisted living facilities educated on the topic of Alzheimer’s disease
 Minister
Instructions for Facilitators:
1. The Facilitators will begin by allowing participants to get refreshments, and then they would
introduce themselves to the participants. They will explain their position, such as a nurse, Family
Life Educator, or Minister, and the main purpose of the program.
2. The staff will give a presentation about the goals and objectives of the program. The staff will
make it clear that that the program is designed to be a place where members can disclose any
feelings or concerns they might have and that each member will be treated with respect.
3. The staff will lead the participants in an Ice Breaker so the staff and participants can get
familiar with each other. The participants will be asked their name, what brings them to the
program (loved one diagnosed with the disease or a caregiver of someone with the disease), and
what coping strategies work best them.
4. The participants will then be given a survey about their availability during the week to meet
with one of their small group members.
5. The participants will be placed into their small groups.
6. The group will reconvene to close the session. A staff member will explain the group
Facebook page. The staff member will remind the group members that page is intended for
members to be open and should not be shared with anyone outside of the group. The session will
end with one of the staff members reading an inspirational quote or passage.
Activities
 Activity 1: Introduction of the staff and allow participants to get refreshments if they
would like to. (3:00-3:15)

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 Activity 2: Presentation from the staff about the goals and objectives of the program.
(3:15-3:30)
 Activity 3: Ice Breaker. (3:30-3:45) Go around the room and group members will say
their names, what brings them to the program, and a coping strategy they might have
used in the past to get through a tough situation.
 Activity 4: Participants take a survey to assess their availability during the week. (3:45-
4:00)
 Activity 5: Break into small groups and get to know one another a little more. (4:00-4:20)
 Activity 6: Time for questions for staff. (4:20-4:30)
 Activity 7: At the end of the session, a staff member will explain the group Facebook
page. The Facebook page will be a closed group where members of the program will be
able to post any questions they might have during the week when there is no program
session. These questions can be intended for one of the staff members, nurses, minister,
or for other members of the group to comment on. The members will also use the page to
document their experiences and about their meetings during the week with another small
group member. Then one of the staff members will read an inspirational quote or passage
to close the session. The staff will also give a brief overview of what participants can
expect to learn in the upcoming sessions. The staff members will also remind the
participants that there will be walk-in hours after the session for one-on-one time with
either a staff member, nurse, or minister. (4:30-5:00)
Session2
Goal: Members of the group will learn and be able to recognize the different stages of
Alzheimer’s.
Objectives:
 75% of group members recognize the effects of Alzheimer’s has not only on the person
diagnosed with the disease, but also the effects the disease has on caregivers and loved
ones.
 75% of group members will begin to build support systems with other members in their
small groups and will decide for carrying out this support; even on days that the program
is not scheduled. Members will post on the Facebook when they meet with their small
group and the overall theme discussed during the meeting.
 In 6 months, 75% of members will meet regularly with their small groups to discuss
issues and concerns and provide support; measured by a survey.
Meeting Time and Time Needed to Complete Session:

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 Time: Sunday from 3:00p.m. to 5:00p.m.
 Walk-in hours from 5:00 p.m. to 6:00 p.m.
Materials Needed:
 Pencils/Pens
 Paper
 Worksheet
 Tables
 Chairs
 Food
 Water
 Cups
 Plates
 Napkins
Preparation of Background Materials
 To be able to understand Alzheimer’s fully, the nurses and staff must be educated on the
different stages of the disease. According to Stringfellow (2017), the first stage of the
disease is simple.
1. a person with the diseases shows no impairments. There are no signs of memory loss and
the disease is undetectable.
2. This stage is very mild cognitive decline. The patient will show signs of forgetfulness
every now and then.
3. This stage is more decline in cognition and the forgetfulness becomes more frequent. In
this stage, patients may also begin to start forgetting how to do ordinary everyday household
tasks. A person who is in the first three stages of Dementia technically is not considered
having the disease.
4. In the fourth stage however, a person is in the early stage of the disease. In this stage, a
person will become more forgettable, have difficulty concentrating, problem-solving, and
managing finances. A person may become in denial of their symptoms.

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5. This stage of the disease is considered moderately severe cognitive decline. This stage
brings along major memory deficiencies. People in this stage will also need assistance in
daily activities, such as bathing, getting dressed, and cooking.
6. The sixth stage is the stage when people have a very difficult time recalling anything. Not
only has their memory declined, other parts of their body begin to malfunction, such as their
bowel.
7. The last stage of Dementia is when people have lost their ability to communicate and
speak and they need around the clock assistance. They also may lose their ability to walk. It
is important for the staff to be knowledge about each stage of Dementia and what happens in
each stage to be able to explain to the participants of the program what they should expect as
the disease progresses.
 At the beginning of the session, the staff members will allow the group members to get
refreshments if they would like to. Then, the nurses will give a presentation over the
different stages of Alzheimer’s and what changes happen in each phase. Next, the nurses
will handout worksheets for the participants to fill out. This worksheet is to help the
participant figure out what stage of Alzheimer’s their loved one/patient is in. Next, the
participants will break-out into their small groups for discussion about the different stages
of the disease their loved one or patient is in. One of the discussion questions the small
groups will be asked is what do you find to be the most stressful part for you about
having a loved one/patient with Alzheimer’s. After small group time, the group will
come back together to close out the session. The session will end with one of the staff
members reading an inspiration quote or passage.
Activities:
 Objective: All members will understand the effects of Alzheimer’s has not only on the
person diagnosed with the disease, but also the effects the disease has on caregivers and
loved ones.
 Activity 1: Members of the group will be given a worksheet to fill out to explain the
stage of the disease their patient or loved one is in by writing down the symptoms they
can identify. (3:00-3:15)
o Question 1: What are some of the symptoms you can identify?
o Answer examples:
 Forgetting recent events
 Unable to keep up with household bills

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 Have trouble with balance and ability to walk without assistance
o Question 2: How might these symptoms look different in another Alzheimer’s
patient?
o Answer example:
 Difference in temperament
 Declines in different abilities
 Activity 2: Nurses will give a presentation about the different stages of Alzheimer’s
and explain that each stage might look different, depending on the patient. This activity
will give participants a clear description of each stage of the disease. (3:15-3:45)
o Question 1: What Stage of Alzheimer’s is your loved one or patient in now?
o Answers:
 Early Stages
 Moderate Cognitive Decline
 Moderately Severe Cognitive Decline
 Severe Cognitive Decline
 Late-Stage Dementia/Very Severe Cognitive Decline
o Question 2: What has been the most difficult stage of the disease you have had
to deal with and what makes it difficult?
o Answer examples:
 Stage four; Patient forgetting family members
 Stage six; Patient unable to care for themselves
 Stage seven; Patient unable to communicate and speak
 Objective: 75% of members will begin to build support systems with other members in
their small groups and will decide for carrying out this support; even on days that the
program is not scheduled. Members will post on the Facebook when they meet with their
small group and the overall theme discussed during the meeting.
 Activity 1: Members will break out into small groups to discuss what stages of
Alzheimer’s their patient or loved one is in. They will talk about the struggles they face
in these stages and discuss strategies of how to deal with the emotional stress the
different stages of the disease have on the people impacted; whether it is the patient,
caregiver, or loved one. (3:45-4:15)

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o Question 1: What do you find to be the most stressful part for you about having a
loved one/patient with Alzheimer’s?
o Answers
 Having to keep repeating oneself to the patient
 Having to help with simple everyday activities, such as dressing, bathing,
and cooking meals
o Question 2: What do you find might be the most stressful part about having the
disease for the patient with Alzheimer’s?
 Not being able to remember family members or important memories
 Not being able to simple every-day activities on their own
 Activity 2: In small groups, members will discuss whether their patient is in an
assistance home or in their home with an around the clock nurse. Participants will
discuss whether caring for the patient puts a strain on their finances and how they plan
on dealing with the issue. (4:15-5:00)
o Question 1: Is your patient in an assistive care facility or is the patient at home
with assistance of an around the clock nurse?
 Answers:
 Assistive care facility
 At home with an around the clock nurse
o Question 2: Does caring for your patient put a strain on family finances?
 Yes
 No, but it still is very expensive for the care
Session3
Goal: Members of the group will learn about different forms of coping strategies.
Objectives:
 Throughout the session, 75% of the members of the group will discover what coping
strategies work best for them and how to utilize these coping strategies to deal with the

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 75% of the members will meet up or call another member of their small group once a
week to provide support to one another. The group members will document who they
talked to and what they discussed on the group Facebook page.
 In 6 months, 75% of the group members will feel confident in confiding with their small
group members; measured by a survey.
 Sunday from 3:00p.m. to 5:00p.m.
 Walk-in hours from 5:00p.m. to 6:00p.m.
Materials Needed:
 Pencils/Pens
 Paper
 Broachers
 Tables
 Chairs
 Food
 Water
 Cups
 Plates
 Napkins
Preparation of Background Material:
 In order for the staff members be able to explain to the participants why coping is
important when dealing with a patient with Alzheimer’s, they must learn about effective
coping strategies. Arnold (2014) lists 10 coping strategies for people dealing with
Alzheimer’s patients:
1. Be flexible; adapt to the person's preferences
2. Help the person stay as independent as possible
3. Guide by using easy, step-by-step directions

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HEALING TOGETHER
4. Speak in short and simple words
5. Avoid rushing the person through a task
6. Encourage, reassure and praise the person
7. Watch for unspoken communication
8. Experiment with new approaches
9. Consider using different types of products, such as large-grip toothbrushes or
bathing chairs
10. Be patient, understanding and sensitive. (Arnold, 2014)
Arnold reports that understanding the different stages of Alzheimer’s can help lessen the
stress and difficulties that comes with the different behaviors. She also reminds loved
ones and caregivers that although it is very important to care for the patient, the loved
ones and caregivers must also remember to take care of themselves. Some of the most
important coping strategies she lists is to be flexible, help the patient stay independent as
long as possible, and be patient. It is important for the staff to give a lesson about coping
strategies so loved ones and caregivers will know the importance of taking care of
themselves as well as the patient.
 Staff members will begin the session by allowing participants to get refreshment if they
would like to. A staff member will then give a presentation about why it is important for
loved ones and caregivers of Alzheimer’s patients to cope. The presentation will also
consist of examples of coping strategies that loved ones and caregivers can use. Then,
members will break into their small group and share what coping strategies they have
found that have worked for them in the past. This way, other small group members will
understand which ways their group members like to cope, and they do not pressure them
to cope in a way that might make them uncomfortable. Also, members can get ideas of
ways to cope by other members sharing their preferences. While in the small groups,
members will fill out a work sheet to determine how well they cope in certain situations.
If they have been through a similar situation as the one they are in now, they can get an
idea of what coping strategies work bests for them. The end of the session will be time
for members to talk to nurses, staff members, a Chaplin, or other members of the group
for support. The session will close with one of the staff members reading an inspirational
quote or passage.

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HEALING TOGETHER
Activities:
 Objective: Throughout the session, members of the group will discover what coping
strategies work best for them and how to use these coping strategies to deal with the
 Activity 1: Staff members will give a presentation of different coping strategies that
work best for people who are impacted by diseases like Alzheimer’s. (3:00-3:30)
o Question 1: What are coping strategies that best work for you?
o Answers:
 Praying about it
 Writing down feelings
 Discussing with another person who may be knowledgeable on the
subject or maybe going through a similar experience
o Question 2: What is another difficult time in your life where you might have
had to use similar coping strategies?
o Answers:
 Death of a loved one
 Losing a job
 Not getting into dream school
 Activity 2: Members will break into their small groups to participate in a scenario
activity. Each group will get a scenario of an Alzheimer’s patient. Depending on the
scenario, the group members will either act as the spouse, child, or caregiver of the
patient. The small groups will be provided with three guiding questions to determine
the best way to handle the situation. (3:30-4:00)
 Example Scenario: Your spouse is in the third stage of Alzheimer’s. They have slight
confusion and difficulty concentrating. You are still working during the day, but your
spouse is no longer working and stays at home. They often forget to eat lunch and takes
their medicine during the day because you are not around to remind them. You get
frustrated when they forget these simple tasks. They still remember who remember
who you are, remember their family members, and their close friends.
o Question 1: In this situation, how can I be more proactive, instead of reactive?
o Answers:

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HEALING TOGETHER
 Instead of getting frustrated that they do not take medicine and forget to
eat lunch, you could leave a daily reminder to take medicine and eat
lunch or call them during the day during lunch to tell them to eat lunch
and take medicine.
o Question 2: Despite the negatives, what are some positives I can identify?
o Answers:
 They still remember who you are, who their family members are, and
their close friends
o Question 3: How do I want to manage my frustration in this challenge the next
time it arises?
o Answers:
 Remember that this is not something they can help. Even though it can
be frustrated for you at times, remember that they are probably more
frustrated with themselves when they do not remember. Let go of the
unrealistic expectation that they will remember to do these tasks, even if
you remind them before you go to work to take their medicine and to
eat lunch.
 Objective: Members will meet up or call another member of their small group once a
week to provide support to one another.
 Activity 1: In their small groups, members will answer a few questions to determine
how well they cope in certain situations. They will discuss their answers with the
members of their group. (4:00-4:30)
o Question 1: When something traumatic happens to you, what do you usually
tend to do?
o Answers:
 Talk to someone who has been through a similar situation
 Shut down
 Look for answers of why this situation has happened to you
o Question 2: How long did it take you to get over this traumatic event and what
coping strategies contributed to this healing process?
o Answers:

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HEALING TOGETHER
 However long it took that person to overcome the traumatic event; by
praying about the situation and by confiding in a close friend who had
been through a similar situation.
 Activity 2: Depending on what type of coping strategies work best for each member of
the group, there will be time at the end of the session to meet with either a nurse or a
minister to discuss issues and concerns one might have. This can be a time for the
members to ask any questions they have to nurses and a minister about why this disease
is affecting their loved one. (4:30-5:00)
o Question 1: What type of coping strategies work best for you; religious or
knowing the facts by talking to a nurse?
o Answers:
 Praying about the situation
 Talking to a person who is knowledgeable about the situation
 Talking to others going through similar situations
o Question 2: Even if someone uses different coping strategies than you, how will
you be respectful of others’ choices?
o Answer:
 Understand that everyone is different, and people choose different ways
to cope
Session4
Goal: Members will be able to use the knowledge gained from the program to better
communicate with their loved one/patient diagnosed with Alzheimer’s.
Objectives:
 75% of the members will pick a day each week to sit down with their loved one/patient
and remind their loved one/patient about memories, family members, and friends.
 In 6 months, 75% of the members will be comfortable with discussing the stages and
effects of the disease with their loved one/patient without feeling any guilt; measured by
a survey:

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HEALING TOGETHER
o From 1 to 5; with 1 being not comfortable at all and 5 being very comfortable
how comfortable are you in disclosing your feelings to members of your small
group?
o How often do you communicate with other members of your small group? Once a
week, once every two weeks, once a month, never.
Materials Needed:
 Pencils/Pens
 Paper
 Tables
 Chairs
 Food
 Water
 Cups
 Plates
 Napkins
Objective 1:
 Activity 1: The staff will give a presentation to the group about ways to talk to their
loved one/patient who is diagnosed with Alzheimer’s. They will learn ways of how to
communicate to the patient about what stage of Alzheimer’s they are in, and ways to be
strong during this process, even if the patient might become upset.
o Question 1: What have you found to be the best way to communicate to your
loved one/patient about their disease?

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HEALING TOGETHER
o Question 2: How do you handle situations when your loved one/patient might
become upset?
 Activity 2: Members will break into their small group and discuss their loved
one/patient temperament and receive feedback from the group about ways, depending
on temperament, they should go about discussing the disease to them.
o Question 1: What type of temperament does your loved one/patient have;
depressed or happy?
o Question 2: How do you change your style of communication based on the
temperament your loved one/patient has?
Objective 2:
 75% of members will pick a day each week to sit down with their loved one/patient and
remind them about memories, family members, and friends.
 Activity 1: Members will create a scrapbook of pictures and memories for their loved
one/ patient with Alzheimer’s, so they will have a visional of the memories they can
look at when they need a reminder.
o Question 1: What are some of the best memories of you and your loved
one/patient?
o Question 2: What are some important dates and events that have occurred in
your family?
 Activity 2: At the end of the session, there will be nurses and a minister around again to
talk with, depending on what type of coping strategy the member might prefer.
o Question 1: What are any final questions that members might have about the
program?
o Question 2: After learning from the program, what are some of the things
members have found that have helped them deal with the situation they are in?
Session5
Goodbye Session
Goal: Members will be able to comprehensively identify the progression of Alzheimer’s and
take away valuable coping skills from this program.
Objectives:
 75% of members will understand the effects that Alzheimer’s has on not only the patient,
but other people who might care and love the patient.
 75% of members will meet up with one another, at least once a week, to discuss feelings,
emotions, and experiences and give support. Members will post on the group Facebook

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HEALING TOGETHER
page to document their meeting times and the overall theme discussed in the small
groups.
 Measured by a survey, in 6 months, 75% of members will have built peer networks and
will have and understanding of the disease and use coping skills to deal with the stressors
of the disease.
Meeting Time and Time Needed to Complete the Session
Materials Needed:
 Pencils/Pens
 Paper
 Tables
 Chairs
 Food
 Water
 Cups
 Plates
 Napkins
 Computers
 At the beginning of the session, the staff members will allow members to get
refreshments if they would like. The staff will do a quick review of what members have
learned about past sessions. Then, participants will break into their small groups for
support. The staff will then pass out a survey to each participant to figure out how helpful
the program was. At the end of the session, the staff will ask if there are any final
questions and remind the group of the Facebook page where the participants, staff, and
nurses can stay connected even though the program is over. The session will end with one
of the staff members reading an inspirational quote or passage.
Activities:

30
HEALING TOGETHER
 Activity 1: A review of what was learned and discussed in previous sessions.
 Activity 2: Members will break into their small groups for a final discussion about
whether the small group was helpful throughout the process of the program.
 Activity 3: Staff will give participants a survey to determine if the program was helpful.
o Question 1: What was your overall purpose for attending the program?
o Answers:
 Have a family member with Alzheimer’s
 Want to learn more about the disease
 Want to build a support system
o Question 2: What part of the program did you find to be most helpful for you>
o Answers:
 Learning about the progression of the disease
 Building support systems
 Learning valuable coping skills
o Question 3: What would you change about the program?
o Answers:
 If they would change anything about the program or not
o Question 4: Would you recommend this program to someone else?
o Answers:
 Yes
 No
 Activity 4: Come back together as a group and say our final goodbyes. The staff will also
remind the participants that there is our Facebook page one can always revisit to ask
questions, share experiences, or receive advice.

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HEALING TOGETHER
Evaluation
1. How was your overall experience with the program?
2. What feels most challenging or worries you about your situation?
3. What did you find to be most helpful about the program?
4. What did you find to be least helpful about the program?
5. How often do you still refer back to the Facebook page?
6. What kind of challenges are you still facing?
7. What are some improvements you have seen in the way you handle situation with
your loved one with Alzheimer’s or patient?
8. How has the condition of your loved one or patient changed since you began the
program?
9. Will you continue to use the resources provided by the program?
10. Overall, what have you learned?

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HEALING TOGETHER
References
Arnold, J. (2014). Coping Strategies for Alzheimer’s Caregivers. BJC Health Care. Retrieved
from https://www.bjceap.com/Blog/ArtMID/448/ArticleID/108/Coping-Strategies-for
Alzheimers-Caregivers.
Correa, M., Giacobbo, B., Vedovelli, Kelem, et al. (2016). Age Effects on Cognitive and
Physiological Parameters in Familial Caregivers of Alzheimer’s Disease Patients.
Retrieved from
http://eds.b.ebscohost.com/eds/pdfviewer/pdfviewer?vid=17&sid=398a9785-db59-47d0-
9962-ab198e6a36fd%40sessionmgr102.
Eifert, E. (2017). Religious Coping While Providing Care for Someone with Alzheimer’s
Disease. Retrieved from
http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=10&sid=1a3be641-d048-4c2d-
a9ed-d0d680b7acc8%40sessionmgr4009.
N.A. (2018). Creating objectives. Community Toolbox. Retrieved from
https://ctb.ku.edu/en/table-of-contents/structure/strategic-planning/create-
objectives/main.
Simpson, G., Stansbury, K., Wilks, S., et al. (2017). Support Groups for Alzheimer’s Caregivers:
Creating Our Own Space in Uncertain Times. Social Work in Mental Health, 16 (Issue 3)
303-320. Retrieved from https://www-tandfonline-com.proxy-
remote.galib.uga.edu/doi/pdf/10.1080/15332985.2017.1395780?needAccess=true.
Stringfellow, A. (2017). The 7 Stages of Alzheimer’s Disease: What to Expect from Preclinical
Alzheimer’s Disease to End-Stage Alzheimer’s. Caregivers Homes. Retrieved from
https://blog.caregiverhomes.com/the-7-stages-of-alzheimers.
Wilks, S., Spurlock, W., Brown, S., et al. (2018). Examining Spiritual Support Among African
American and Caucasian Alzheimer’s Caregivers: A Risk and Resilience Study. Retrieved
from https://www.sciencedirect.com/science/article/pii/S0197457218300727.
Yu, H., Wang, X., He, R. & Zhou, L. (2015). Measuring the Caregiver Burden for Caring for
Community-Residing People with Alzheimer’s Disease. Retrieved from
http://eds.b.ebscohost.com/eds/pdfviewer/pdfviewer?vid=5&sid=a9c3de2f-9a9e-4f72-
8bbf-ba1277fba408%40pdc-v-sessmgr05.

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HEALING TOGETHER
Appendix
Appendix A
1. Session 2 materials

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HEALING TOGETHER
Worksheet:
Name:
Healing Together Session 2:
Identifying the Stage of Alzheimer’s
1. Please list and explain the symptoms you can identify in your loved one or patient.
2. How might these symptoms look different in another Alzheimer’s patient?

40
HEALING TOGETHER
3. Can your loved one or patient get around by themselves without assistance, such as a
walker, cane, wheelchair?
a. Yes. Please list what kind of assistance they use.
b. No
c. Sometimes has to use assistance. If so, what kind of assistance do they use.
4. Is your loved one or patient at home alone, at home with help, or in an assisted living
facility?
2. Session 3 materials

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HEALING TOGETHER
Scenario Activity:
 Scenario 1: Your father has been diagnosed with Alzheimer’s. You are in your mid 30’s.
He is in the fourth stage of the disease. Other than having Alzheimer’s, your father has no
other health problems. He has difficulty concentrating, problem-solving, and managing
his finances. He has begun to withdraw from his family and friends. His wife past away 5
years ago and he is currently living at home alone. He only lives 5 minutes away from
you. You often get frustrated when he forgets simple things and that he is withdrawn
from the family.
 Scenario 2: You are a caregiver of an Alzheimer’s patient who is in an assistive-living
facility. The patient is in the sixth stage of the disease. The patient requires substantial
assistance to carry-out day-to-day activities, such as bathing, getting dressed, and going
to the bathroom. The patient is very forgetful of names. She does not remember your
name and she does not even recognize her own son when he comes to visit her. Her son
gets very frustrated that she does not recognize him without him reminding her that he is
her son. She also has trouble with her speech. You sometimes get very depressed
assisting the patient because she is so helpless and at the fact her son gets very frustrated
with her.
Appendix B

48
HEALING TOGETHER
1. Welcome Guide for Participants
Welcome Guide for Participants
relationships for support.
Vision of the Program:
 To provide family members and caregivers of Alzheimer’s patients education of the
disease, a peer network for support, and a safe environment for emotional disclosure and
support.
Meeting Time:
 Time: Every other Sunday of the month from 3:00p.m. to 5:00p.m.
 Where: At a local Church’s social hall
 Walk-in Hour after the session for one on one time with a staff member or nurse:
5:00p.m. to 6:00p.m.
Facilitators of the Program:
 Family Life Educators
 Nurses from assisted living facilities educated on the topic of Alzheimer’s disease
 Minister
Ground Rules:
 We want to provide a safe and open environment where everyone feels welcomed.
 Stories and experiences are to be kept confidential and should not be discussed with
people outside of the program.
Expectations for Group Members:
 Expected to come to every session and stay for the full two hours

49
HEALING TOGETHER
 Expected to participate in small group time
 Expected to be active listeners
Group Facebook Page:
 The Facebook page will be entitled ‘Healing Together’. Each group member will receive
an invitation to join the group. The page will be a closed group where members of the
program will be able to post any questions they might have during the week when there is
no program session. These questions can be intended for one of the staff members,
nurses, minister, or for other members of the group to comment on. The members will
also use the page to document their experiences and about their meetings during the week
with another small group member.
2. Welcome Guide for Facilitators
Welcome Guide for Facilitators
relationships for support. Presentations will be given by nurses and staff members about
Alzheimer’s and its effects on both the patient, loved ones, and caregivers. There will
also be times during each session where the participants of the program will break into
small groups to build peer networks and to discuss concerns and feelings they might
have. This program is geared towards people of Christianity, and there will be a minister
available at each session for members to talk to. “Religious coping has been found to
mediate and moderate the relationship between stress and health” (Eifert, 2017, p. 221).
This support can be beneficially for the family members and caregivers’ health and
overall well-being.
Session1:
 Introduction of the facilitators and group members
 Presentation about the goals and objections of the program
 Introduction of the Facebook Page

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HEALING TOGETHER
 Survey of time availability during the week for participants
 Divide into small groups
 Reconvene to close the session
Session2:
 Worksheet about symptoms and stages of Alzheimer’s that participants can recognize
about their loved ones or patients
 Presentation about the 7 stages of Alzheimer’s
 Small group discussion; facilitators will walk around to the different small groups to
make sure their conversations are on topic
 Reconvene to close the session
Session3:
 Presentation about different coping strategies
 Scenario activity in small groups; facilitators will walk around to small groups to make
sure their conversations are on topic
 Conversation in small groups about individuals’ experiences
 Reconvene to end session
Session4:
 Presentation about how to communicate with loved one or patient about Alzheimer’s
 Small group discussion about their loved ones and patients; facilitators will walk around
to make sure conversations are on topic
 Scrapbook activity in small groups led by facilitators
 One-on-one time with members of the group with facilitators, nurses, or ministers
Session5:

51
HEALING TOGETHER
 Review of the program
 Small group final discussion; facilitators will walk around to make sure conversations are
on topic
 Facilitators will give out surveys to participants about their overall experience with the
program
 Reconvene for final goodbye

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