It is difficult to overstate the horrors of Alzheimer's disease for patients and their families. But support groups can offer some relief – in providing caregivers both perspective and practical advice.

Judy Hamilton of Colchester visits her mother every evening at Gardenview, the memory support wing of the Converse Home in Burlington. Since April, she has been attending a support group for people who have family members there.

"Before I joined the group, I felt alone," Hamilton says. "I didn't know that so many of my feelings and experiences were common." Hamilton had lost her temper and felt exasperated and guilty when her mother kept repeating that she wanted to go home. Support group members recognized her plight and suggested that she not try to reason with her mother because an Alzheimer's patient does not understand. "They helped me to deal with what was going on," she says, "how to turn the conversation to other topics instead of always having a losing argument."

In December, Carrie Shamel, Gardenview Program Manager, started a new monthly support group for people who care for their family members at home or support them in early-stage dementia through the traditional Converse program or at other assisted living facilities. The group meets on the first Tuesday of every month, from 4:30 – 6:30 pm (next meeting February 5) with a wide range of discussion topics – from financial issues to fears about Alzheimer's genetic linkages, from tips on coping to community resources, from knowing what to expect in the course of the disease to negotiating help with family members.

"The number one and hardest lesson for families is to accept their reality," Shamel says. A woman might ask about her husband's health, forgetting that he had died. "Don't argue," Shamel advises. "Reminisce about her good memories with her husband, and then change the subject." If a father complains that he hasn't seen his daughter in a long time, even though she visited him yesterday, "Don't confront him," Shamel says. "Agree that it may seem like a long while, but you are here now."

Shamel maintains that Alzheimer's disease is not a dark and depressing illness – at least for the patient. She says that forgetting can often make life easier, citing a new resident who came to Gardenview after husband and caregiver died. She decided that her spouse had died years ago and that she no longer had to mourn him. Shamel notes that while cognition may dwindle in Alzheimer's patients, other capabilities – most notably expressing and understanding emotions – seem to pick up. A caregiver's body language and expressions mean more than reasoned words.

Alzheimer's patients live in the moment, Shamel says, which can be a source of joy for them and a lesson for caregivers. Kelly Thomas's father is due to move into Gardenview shortly. Instead of rushing him from dinner to the next planned activity, she says that she is learning to take it slow, walk around the block with him, and "appreciate moments of grace."

Nora Sabo of Westford, whose mother is at Gardenview, says that when she started coming to the support group, she was most interested in practical advice and general information about the disease. She appreciated, for example, the guest speakers who outlined the neurological progress of Alzheimer's. More recently, she says, she attends to be with other people who can share her experiences and feelings. "This is a group where you can say things about what Alzheimer's is like on a daily basis, without any judgment," she says. "There are things that you just do not have to explain."

Most people with Alzheimer's disease are cared for at home. "I know how difficult this care is in a controlled setting," Shamel says. "I imagine that it is much more difficult for people at home." For the home caregiver, Shamel advises simple household re-arrangements like taking the knobs off the stove, leaving large-print notes near the telephone, and keeping appointments on a large-print calendar. She emphasizes the importance of getting help – making a detailed list of the tasks to be done and not assuming that everyone knows what they are and that help is needed.

Most important, Shamel says, the caregiver must take care of him/herself. In an airplane, the safety instructor always says that parents should put on their oxygen masks first and then help their children. In the same way, Shamel says, Alzheimer's caregivers must be sure to get sufficient rest and assistance to enable them to give proper care. One way caregivers can help themselves, Shamel says, is by attending a support group.

According to the Alzheimer's Association of Vermont and New Hampshire, some 10,000 Vermonters and 20,000 people in New Hampshire have Alzheimer's disease, with about 90,000 caregivers in the two states.

Alzheimer's Support Groups in the Burlington Area – free and open to the public

• Converse Home, Burlington, first Tuesday, 4:30 – 6:30, Carrie Shamel, 862-0401
• Birchwood Terrace Health Care, Burlington, last Tuesday, 5 pm, Stephanie Catella, 863-6384
• Visiting Nurses Association, Prim Road, Colchester, 3rd Thursday, 10 – 11:30 am, Heather Woods, 658-1900 (For home care-givers regardless of patient's diagnosis)
• The Arbors, Shelburne, 2nd Tuesday, 10-11:30 am, Colleen Morgan-Fossi or Nicole Houston, 985-8600

Barbara Leitenberg writes on senior issues for the Champlain Valley Agency on Aging. This article originally appeared in the Burlington Free Press.