Alzheimer's patients aren't the only ones who suffer because of the disease.

“The stress and strain of being an Alzheimer's caregiver can cause a number of physical and mental problems. Depression is one of the most common,” said Dr. Dennis P. McNeilly, a University of Nebraska Medical Center geriatric psychologist at the Home Instead Center for Successful Aging. “Often, the caregiver is doing what they have to do. They're not thinking about the toll it's taking on them.”

The risk of clinical depression for a caregiver of an Alzheimer's patient can reach up to 50 percent. That person is twice as likely to have clinical depression than a person who is caring for someone without dementia.

“It's terribly difficult to watch someone evaporate in front of you. As Nancy Reagan said, it's ‘The Long Goodbye,'” McNeilly said.

The loved one often does something in public that embarrasses the caregiver. “What was supposed to be a simple dinner is ruined when the Alzheimer's patient goes around asking people if they're going to finish their French fries.”

Dr. Thomas Magnuson agreed. “I become more worried about the caregiver,” he said. “I know what will happen to the Alzheimer's patient. Their lives shrink. They have less contact with friends, do fewer activities and take part less in the community. Respite for caregivers is essential. They need to get out and have their battery recharged.”

Magnuson, like McNeilly, is a UNMC geriatric psychiatrist at the Home Instead Center for Successful Aging. Eighty percent of the people he sees have dementia of some kind. Of those with dementia, 70 percent have Alzheimer's disease.

He often is concerned about the caregiver who shows up in his office with the Alzheimer's patient. “I have one patient. I don't need two,” Magnuson said. He encourages the caregiver to look at services that are available to help.

“At the Home Instead Center for Successful Aging, we provide assessment, counseling and treatment for those who suspect that they or a loved one may have Alzheimer's disease,” he said.

“Patients usually come in when they start noticing changes in memory, language, taking meds and generally taking care of themselves. Maybe they no longer pay bills or are making bad decisions.”

Magnuson takes the patient through a thorough examination — involving cognitive screening tests and talks with the family about what it's observed — and communicates with the primary physician. In some cases, there may be further testing.

Patients can become lifesavers for others down the road if they choose to participate in one of the trial studies at UNMC for new medications intended to treat Alzheimer's disease. It can take years of research to see whether medication makes a difference. Medication at this time does not cure, but may slow, the progress of Alzheimer‘s.

If the patient still lives with the family, the caregiver should consider whether it's time for assisted living.

“Many patients do worse in a less-structured environment. They may become more anxious or depressed at home when they lose the ability to perform activities they normally do,” Magnuson said. “Assisted-living or nursing-home care may relieve the anxiety or depression that impacts the patients' level of cognition. People are surprised how much better they may do when stress is removed.”

Caregivers may become depressed, but so might the patient.

“Alzheimer's patients are more likely to get depressed, and depression leads to ailments such as heart and pulmonary disease,” Magnuson said.

Caregivers who are on call 24/7 may want to rethink their decision to abandon leisurely shopping and visiting friends. Instead, they should ask themselves what their spouse or loved one would tell them if he or she did not have Alzheimer's disease.

“They would want you to spend part of your day doing something you enjoy,” McNeilly said.

While taking care of your loved one, take care of yourself. And ask for help.