Articles Posted in Memory Care

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I am currently in the process of assisting one of my clients who is having issues with her teeth She is 86 years old. I was appointed as her Power of Attorney For Health Care. Recently, the nurse at the assisted living community where she resides informed me that her upper bridge had fallen out. It wasn’t something that could be fixed with a tube of Poligrip. It may have fallen out due to her experiencing some weight loss.. The nurse said she needed to see a dentist. I thought it was fortunate that the assisted living community had just announced the appointment of a new dentist who would visit the community, rather than having the resident travel to his office. Because it seemed so convenient and I didn’t want to agitate her by transporting her to the office, I quickly made an appointment.

After a conversation with the dentist, I requested a pre-treatment estimate for the future dental work. I was told that he was unable to do further work at the assisted living community because a set of x-rays needed to be taken. Furthermore, she had 9 teeth on the top that needed to be extracted. Her lower teeth needed to be deep cleaned. He wanted to build a new upper denture and charge for two adjustments. The bottom line costs would be close to $7,700. My heart sank when I saw the figure.

I called the dentist and asked if there was any financial relief available in his figures. His answer was that he could offer a payment plan but no rate reduction.

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In the past several weeks it seems like I have been deluged with cases involving senior citizens who need to give up there driving privileges. My own Mother is 91 and still independent. Yet, she had enough common sense to relinquish the keys when she realized her age and the effects of her medications could cause her to have an accident. We live in such an auto-dependent society that most seniors don’t take charge of the fact that memory impairment coupled with the effect of medications can impair visual -spacial abilities, reaction time, and concentration behind the wheel.

As a senior living advisor, I have collected copies of the transportation schedules from over 400 communities. Many of the retirement communities offer transportation options that are quite flexible and could be a saving grace in a child’s quest to encourage a parent to stop driving. My REAL LIFE STORY exemplifies how retirement community transportation may help in that regard.

REAL LIFE STORY

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Many of my clients have asked me if they are making a mistake by “preparing too soon,” for a senior loved one’s life changes. My response is you can avoid an emotional and financial crisis by educating yourself with regard to the options for your loved one. Please read the following “Real Life Story” to learn what one of my clients experienced when they were forced into a “rush” decision.

Real Life Story

My clients are a woman and her elderly parents. There is a large age difference between the parents. One is in his/her mid-nineties, while the other is in his/her early eighties. The older of the two parents is totally independent and functioning very well. Unfortunately, the younger parent has dementia, can walk without any assistive devices, and recently began wandering. When a person with dementia wanders once, they will do it again. The parent had held a very prestigious job and was able to talk to me about past responsibilities.

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Sometimes you must face the fact that you are in denial about your senior loved one’s needs. I am sharing the following Real Life Story with you to emphasize that point.

My clients are a family of ten children who attended my, “Senior Living Myths Unmasked,” presentation over three years ago. Their elderly Mother was living alone in a large home. At that time, she had been diagnosed with early onset dementia. The children were divided in their opinions on whether to keep their Mother at home with a caregiver or seek placement in a long term care community. After countless conversations with them, they decided to hire a caregiver on a part-time basis.

The family contacted me recently to advise them on their Mother’s situation which had changed dramatically. The caregiver was helping their mother on a full-time basis. Her finances had changed drastically. Reportedly, she was down to her last $30,000. She owed no money on her home, but the house was not on the market to be sold.

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I just turned 55 on my last birthday. Although some people consider 55 as the official age of becoming a senior, I have never allowed my age to deter me from participating in my hobby of tap and jazz dancing. As a senior living advisor, (and a former, part-time children’s dance teacher of 13 years, hobby only) I am also pleased to see so many of the senior communities offering dance therapy classes to their residents. I have also taught tap and ballet on a voluntary basis in some of the assisted living communities that specialize in dementia care and several senior centers. I was made aware that several of the participants also had Parkinson’s disease.

Exercise that is performed several times a week can help to elevate a person’s immune system and make them feel better about themselves. That is because of the endorphins that are released. The exercise classes provide camaraderie while encouraging seniors to move all of their body parts. If a person moves their limbs, it increases hand to eye coordination, strengthens the core, and helps balance.

I approached the classes as I would have at any other basic level. I included combinations and repetition to Frank Sinatra and Bobby Darin songs. I found that most of my “students,” found ease in doing the tap warm ups, grape vines, and some jazz movements, even if they were confined to a wheel chair. Many of the participants said that their joints felt better, their overall movement improved, and most importantly their spirits had been lifted. After the class had finished, I always served them a snack and we’d talk for a while. Some of the residents with dementia would reminisce about where they used to go to dance with their spouses. One resident in particular spoke about a church in Evanston, Illinois that had a Scottish affiliation and offered Scottish dance lessons. She even went so far as to quote me the exact street address.The repetition of certain exercises helps people with Parkinson’s to concentrate on movements that have become difficult for them, such as doing two things at once. People who have suffered a stroke are able to express themselves by moving to the music even though they can’t talk. Sometimes peoples’ medications stop working for them and the classes give them relief from their symptoms.

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A recent, nationally publicized tragedy involving a woman with memory issues emphasizes the fact that a senior with dementia (even in the early stages) should never travel alone. The woman’s family was aware of the fact that she was having memory issues. Yet, they allowed her to fly from Barbados to Washington alone (flight time approximately four and one half hours) with a layover in Miami. The article states that the family was concerned about her memory issues and planned to have her checked once she arrived back in Washington. It seems to me that she should have been checked prior to doing any travelling. In addition, the woman had poor vision. She walked past an airline agent who was carrying an electronic sign with her name on it. He was to escort her to the baggage area where the daughter was waiting. Her physician would have advised against her travelling alone and the tragedy could have been prevented.

As a senior living advisor, I always tell my clients that a senior with dementia should never travel alone. Here are some other tips that I offer to ease the stress of travelling with a senior who has dementia:

:-Always stay with the person in the airport. Do not turn your back on him/her.

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I am often confronted with some interesting family dynamics when a family hires me to consult with them. At times, the children are willing to accept my advice without reservation. Sometimes, there is often one child who wants to prove that s/he can “do this on her/his own.” While there is usually one child who emerges as the spokesperson for the family, the choice of the right care should be the result of a family consensus and not the persuasive skills of a ringleader. Consensus should be coupled with careful comparison of cost and methods of payment, level of care needed, staffing considerations, location, and quality of care involved with all the senior living options. Please read the following “Real Life Story,” that exemplifies my point

Real Life Story

One of my clients who did not follow my initial advice contacted me last week. She was unhappy with the care that her Mother was receiving at an assisted living community that specializes in memory support.

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When I am hired by a family whose loved one has Alzheimer’s or some other form of dementia, my thoughts immediately turn to my Father. My Mother, who is a registered nurse, insisted upon caring for him at home until his medical conditions forced his transfer to a nursing home. He had been one of the charter physicians who helped open a major hospital in the 1960’s. Because of this fact, my Mother felt obligated to place him a nursing home that was owned by the hospital. It was centrally located for most of my family members, except for my husband and me. We would travel 25 miles every night after work so that I could visit him. The commute exhausted both of us. The poor care resulted in my Mother making a decision to move him to a nursing home that was closer to her, but even further away from us. The care and compassion that he received at the new nursing home was the difference between night and day. I just had to resign myself that I was going to see him less. As a senior living advisor, I always tell my clients that location is important but it shouldn’t be the sole factor in choosing a long term care community.

REAL LIFE STORY

My clients were an 82 year old woman and her children. Their Father was at home with two caregivers who took care of him in 12 hour shifts. He was diagnosed with Alzheimer’s disease. His behavior was becoming very difficult to the point where he was a two person assist. The family was in favor of placing him in a long term care community. There was one child who volunteered to move him into her home. Her intent was hire a number of caregivers to accommodate the two person assist.

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The prospects of alternative living options for people with dementia who are under the age of 65 are not plentiful. Although there are assisted living communities offering memory support for prospective residents under the age of 65, the pay source is strictly private. I have been faced with situations where the prospective resident has been in their early 50s and had severe Alzheimer’s disease. Unfortunately, the family lacked the funding to pay privately at an assisted living community. I had no other option except to assist the family with placing the individual in a nursing home that would accept Medicaid.

As a senior living advisor, I must persuade my customer’s to accept options that are less than optimal because there is nothing else available. In the following Real Life Story, I had the long term solution to my prospect’s problem, but the individual is still contemplating other arrangements.

REAL LIFE STORY My client’s sibling is only 51 and has early onset dementia. The individual was living alone in an apartment quite far away from the rest of the family. The person had worked at the same job for many years until it was apparent that the symptoms caused poor job performance. The person was dismissed from the job. The person had a monthly income of less than $900. The person also had a 90 pound dog that needed to be cared for. Yet, the individual could perform all of the activities of daily living. A recent neuropsychological report stated the person was capable of holding down a job with repetitious tasks. However, her sister was worried about her care on a long term basis and safety issues.

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I have been working with a lot of families who are not familiar with the differences between types of services that are provided at the independent living, assisted living, and nursing home care levels. The result is that they waste a lot of time touring communities that are inappropriate for their loved one. It is even worse when a loved one is placed in a community at the wrong level because it is cheap. I have seen instances where an admissions director often convinces an uneducated family that their loved one can survive at a level of care that is inadequate for their needs. Bear in mind, there are a lot of communities with low censuses and apartment/rooms that need to be filled. The bottom line is that if the senior cannot function at a level of care that is too low for them, s/he is the one who suffers!

A Real Life Story Continued From Chicago Senior Living Advisors Blog November 18, 2012

I had written a partial Real Life Story about this incident recently. Here is part two of the story. My client is an 86 year old woman. I am her Power of Attorney For Health Care. She has severe short term memory issues, is incapable of handling her finances and medications, and as of late needs standby help with her activities of daily living. Her former Power Of Attorney For Healthcare (who resigned from the position and resides out of state) placed her at the independent level because it was cheap. Independent living means the senior can function on their own, with some help with housekeeping and meal preparation. I was assigned to the position the day before she was supposed to move. She was already objecting to the move. It was too late and she really needed to be in an environment that had some semblance of supervision. In my opinion, she really needed to be in an assisted living community with a memory care unit. Memory care units provide structured activities, 24 hour supervision, and heavy cuing plus standby assistance with activities of daily living.

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