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How to Be a Caregiver for Someone With Arthritis

Learn ways to help reduce their pain and improve their lives

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If you care for someone with arthritis, there’s a lot you can do to help — from assisting with medications and diet to finding ways to make everyday tasks less painful. Little things can mean a lot.

Larry Mullinax, 78, a retired dentist from Hixson, Tennessee, says one thing he did for his late wife, Barbara, who had spinal osteoarthritis and other serious health problems, was to put comfy cushions in his car so she could ride more easily. When she showered, he stood nearby, ready to help. When even walking to the kitchen became a trial for her, he brought her breakfast in bed every morning.

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“I was willing to do anything I could to make it better for her,” Mullinax says. Barbara passed away in January, at age 77, due to complications of multiple health problems, including a rare liver disease.

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Larry Mullinax, of Hixson, Tennessee, with his late wife Barbara.
Courtesy Larry Mullinax

Arthritis, which means joint inflammation or damage, can come in more than 100 forms, causing pain, swelling, stiffness, and limited movement. Some older people with arthritis need a lot of hands-on support; others don’t.

Here’s what caregivers should know and what they can do.

Understand that arthritis is not a single condition

Joints are the points where two bones meet. Arthritis can affect one, a few or many joints, including big joints like your knees, elbows and hips; smaller joints in your fingers and toes; and those that line the spinal column along your neck and back. It’s important to know what kind of arthritis your loved one has, say rheumatologists, doctors who specialize in arthritis.

The major types include:

Osteoarthritis: This most common type happens when the cartilage inside a joint breaks down, reducing the cushion between bones. It’s thought to result from wear and tear, and gets more common with age. Obesity and joint injuries increase risks. Compared with other types of arthritis, “it’s more of a mechanical issue,” though there’s a debate about the role of inflammation in osteoarthritis, says J. Eugene Huffstutter, M.D., a rheumatologist at Arthritis Associates in Hixson, Tennessee.

Rheumatoid arthritis (RA) and other autoimmune, inflammatory diseases: RA is the most common of these conditions, in which the immune system attacks healthy joint tissue, causing inflammation. RA also can attack the heart, lungs and eyes. Other types include psoriatic arthritis (which can accompany skin psoriasis) and ankylosing spondylitis, which affects the spine. Arthritis also can be a part of autoimmune conditions such as lupus and scleroderma.

Gout and pseudogout: These types are caused by a build-up of crystals in the joints. In gout, the crystals come from excess uric acid in the body. It usually affects the big toe. Pseudogout is linked to a different crystal, calcium pyrophosphate dihydrate, and most often affects knees.

If your loved one lacks a definite diagnosis, some tests are in order, says Cuoghi Edens, M.D., a rheumatologist and assistant professor of medicine at University of Chicago Medicine. The most basic test: X-rays.

“They actually can help us determine what type of arthritis someone does have,” Edens says.

Ultrasound or CT scans can also be useful, she says, along with blood tests for inflammation and levels of uric acid. In some cases, the doctor will draw fluid from an affected joint to look for inflammation, crystals or signs of infection.

Know your loved one’s arthritis management plan

Treatment can include medications, physical and occupational therapy, lifestyle changes and, sometimes, surgery. To understand it all, it helps to join your loved one for medical appointments, doctors say.

“Whenever I see a new patient, I’m very happy when there’s a spouse or a significant other or [an adult] child with the patient,” Huffstutter says. A caregiver can help fill in details that people in pain might forget or minimize, he adds. Huffstutter remembers one man who said he had no trouble putting on his shoes and socks. His wife clarified that it was because she did it for him.

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Learn about arthritis medications

For osteoarthritis, the main drug options are standard painkillers, such as ibuprofen and acetaminophen. Some people get prescription painkillers. Steroid injections sometimes offer temporary relief.

“Unfortunately, there aren’t any medicines to necessarily stop osteoarthritis from happening or from progressing,” Edens says.

But for inflammatory forms of arthritis, such as RA, Edens says, “I have medicines that can decrease the inflammation that’s going on and prevent further damage from happening.”

Those medications are known as DMARDs, or disease-modifying antirheumatic drugs. They suppress immune system activity and include inexpensive prescription pills that have been around for decades, as well as pricier drugs called biologics. The biologics target specific molecules, cells and pathways involved in inflammation and joint damage. They’re given as injections, IV infusions or pills.

About half of patients do just fine on older, cheaper DMARDs such as methotrexate, Edens says.

While biologic costs are high, “all these medicines are very well covered by insurance or by copay assistance,” says Nilanjana Bose, M.D., a rheumatologist at Lonestar Rheumatology in Houston. “I have not yet had a patient who has not been able to [access] these medicines due to cost.”

Gout also is treated with painkillers and anti-inflammatory drugs and sometimes with medicines that lower levels of uric acid, according to Mayo Clinic.

Consider occupational and physical therapy

If your loved one struggles with everyday tasks, from cooking to brushing their teeth, an occupational therapist (OT) can help. “Our entire job is about helping you function better in everyday life,” says Cheryl Crow, a Seattle-area OT who has rheumatoid arthritis and hosts the Arthritis Life Podcast. OTs are experts in daily habits and gadgets that can make life easier, she says. Something as simple as learning to hold a mug in two hands or putting foam tubing on a toothbrush handle can make a big difference, she says.

A physical therapist (PT) can show your loved one how to get stronger and regain movement in stiff joints, with exercises that are safe for them, Edens says. Physical therapy also helps people preparing for or recovering from joint replacement surgery, she adds.

A caregiver who comes along for these appointments can learn a lot, the experts say.

Mullinax says he used to videotape his wife’s PT sessions to help her do her exercises correctly at home.

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Make the home safer and easier to navigate

When Lara Manuela Austin Shoop, 55, a ceramics artist in Sonoma, California, was teaming with her brother and husband to care for her father in the last year of his life, she says they did all they could to make his condo safer for a man with debilitating osteoarthritis. They pulled up the rugs he might trip on, put a riser on his toilet, added grab bars in the bathroom and bought him several different shower stools until they found one that worked.

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Lara Manuela Austin Shoop with her dad Eugene (Gene) Dale Austin on her wedding day in 1998.
Courtesy Austin Shoop

But his favorite device, she says, was the simple grabber tool he used to get objects from his perch on the sofa.

Crow says other good household tweaks include replacing door and faucet knobs with easier-to-use levers, and putting essential kitchen items between shoulder and hip level.

A physical therapist or other expert can check your home for safety and suggest improvements, Edens says. You can ask your doctor or your Area Agency on Aging for referrals.

Support a joint-healthy lifestyle

Caregivers can play “a big role” in encouraging people with arthritis to be active, eat well and make other joint-healthy choices, Bose says.

Physical activity is the best way to control osteoarthritis and is important “no matter what type of arthritis they have,” Edens says. Low-impact activities like walking, biking and swimming can safely ease arthritis pain and improve joint function for most people, according to the Centers for Disease Control and Prevention (CDC).

Diet matters too. High-sugar diets are “very pro-inflammatory,” Bose says. And studies suggest a Mediterranean diet — focusing on fruits, vegetables, olive oil, nuts, whole grains and fish, and low in red meat and sugar — can reduce inflammation and even help people take fewer pain medications, Edens says. That diet is also good for your heart, she notes.

People with gout need a more specific diet that limits foods high in substances called purines, as well as alcohol and sugar, Edens says. Purines, which increase uric acid production, are high in red meat and some seafoods, including anchovies, shellfish, sardines and tuna, according to Mayo Clinic.

Staying active and eating well can help control weight, Huffstutter says. Excess weight makes joints hurt more, leading to a vicious cycle, he says: “The more you hurt, the less you move.” That, he says, can lead to more weight gain and more joint damage.

Smoking also can make arthritis worse, Huffstutter says: “It’s well known that patients who smoke with an inflammatory arthritis like rheumatoid do less well than the patients that don’t.”

Provide emotional support

Crow says she often hears about loved ones who say things like “You just need to push through … it’s just arthritis.”

That’s not helpful, she says. “People are not faking being in pain” or feeling exhausted, she says. Accept that “you’ll never know what it’s like to be in someone else’s body,” and offer them your support when they struggle, Crow urges. That kind of support can reduce a loved one’s experience of pain, she says.

Shoop says her best advice is to be patient. “Give yourself a lot more time than you think you’ll need, like if you have an appointment,” she says. Getting showered, dressed and into a vehicle can be hard for someone like her late father, she says. “When you’re rushing without allowing for that extra time, it just puts stress on everybody.” 

Do Arthritis Supplements Work?

Many people with arthritis use supplements and swear by them. Here’s what to know about some popular choices:

Glucosamine and Chondroitin: Studies reported by the National Center for Complementary and Integrative Health (NCCIH), which focus mostly on knee pain from osteoarthritis, are mixed on whether these supplements, made from substances found in cartilage, reduce pain. But “it’s a fairly inexpensive and safe supplement,” says Chicago rheumatologist Cuoghi Edens.

Turmeric: A review of a small number of studies in BMJ Open Sport & Exercise Medicine found that supplements containing this common spice might work as well as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to improve knee pain and function in people with osteoarthritis. Turmeric might be worth trying for people who can’t take NSAIDs, Edens says.

Collagen: Limited research suggests taking collagen, a building block for cartilage, might help reduce osteoarthritis pain, according to the Arthritis Foundation. But Edens says she’s skeptical: “There’s not a way for that compound to actually get inside the joint and improve collagen.”

Edens says it’s important to ask your loved one’s doctor about any supplement they take. Some might be harmful when combined with medications. For example, she says, supplements of omega-3 can increase bleeding risk, just as NSAIDs do.

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