dementiadvice

Just another WordPress.com site

Masking Memory Loss

As children grow up and leave the nest, they often spread out to different cities and even states. Career opportunities, a desire to live in a different environment, or the location of spouse’s family are just some of the reasons for moving away from their home town. Sometimes, they just need a little breathing room from their siblings or an overbearing parent. Family relations don’t ease with distance but may possibly soften over time. That is until, family members are confronted with a difficult situation.

Let’s say for example Joe, the oldest son, moved to the East Coast shortly after graduating from college. He made a point to visit twice a year, until the demands of his own family and job prevented him from making regular trips back to California. The youngest daughter Julia became a nurse and remained close to her parents in their home town. She and Joe had opposite temperaments and often did not get along. Julia is a natural caregiver and realizes how much she needs to compensate for her mom’s lapses in memory and ability to complete complex tasks. This has been taking its toll on her energy and is affecting her relationship with her own husband and kids. When Joe comes to visit, Mom is on her best behavior.  He doesn’t understand why Julia is so concerned about their mom’s decline. He resists any notion that mom has slipped.  Julia accuses him of being in denial. She becomes angry with Joe because he doesn’t see the sacrifices Julia is making for their mom.

Often times, those who are closest to the person experiencing memory loss are more likely to accurately assess the situation. Family members who are more remote, either physically and/or emotionally don’t seem to accept that there is a problem.

Those in the earlier stages of memory loss often practice a phenomenon I like to call “performing.” They realize they are expected to respond in a certain way while in a familiar situation. In the example above, Mom seems perfectly fine because she is performing. Conversations seem to flow easily because she is in complete agreement with Joe’s comments. She may not be able to articulate that it is hot outside, so she replies “Isn’t that the case.” when Joe remarks on the summertime. She will cover up the fact that she shoes are on the wrong feet because they are so comfortable that she didn’t even notice. She will ask Joe to set the table because he is so good at it, rather than reveal she can’t remember which side to place the fork.

The best way to get a remote sibling to see the real behavior of their parent is to identify the times when, in Joe’s case, mom is performing. He could make a statement that is clearly nonsensical and listen to mom agree. By gently challenging mom to do something spontaneously,  Joe could observe that lost look in her eyes, and perhaps frozen body language. When mom doesn’t know that he is watching, she is likely to reveal herself the way Julia sees her.

When family members can work together to accurately assess memory loss in a parent, they are in the best position to seek the appropriate level of care. Denying or delaying medical treatment for the parent and support for the caregiver is an injustice to the entire family.

 

 

Leave a comment »

Breaking the News

Breaking the news to a parent that it is time to move from their home into an assisted living facility is one of the most difficult tasks according to most of the families we meet. While some individuals welcome the benefits of living into a senior community, many fear their loss of independence and are not ready to face their inability to care for themselves. We have seen many approaches, and just as individual personalities and situations vary, so do the successful ways in breaking the news.

It is helpful to bring up the idea on several occasions. Mom or Dad will likely resist at the first mention of assisted living, but may warm up to the thought over time. We recommend that you do some research before bringing up the subject. Pre-screen a few communities you think would fit Mom or Dad’s needs. Then, talk to them about their preferences for living arrangements and explore options together. Most communities have web sites where you can take a “virtual tour.” Check out the community’s reputation with their licensing agency, the local Ombudsman’s office and the Alzheimer’s Association. Once you have selected a few, make an appointment for a tour and bring your parent with you. By encouraging their participation, they will become more invested in the idea. Once your parent learns about their living arrangements, activities and comforts of care, they may look forward to moving.

Decorate their new room or apartment before the move. Many communities will encourage bringing bedding, furniture, pictures, and memorabilia. Familiar belongings will trigger feelings of comfort and security. Do not bring valuables or items that you won’t mind getting misplaced or damaged.

Perhaps your parent is very stubborn and absolutely refuses to talk about the idea of moving into assisted living. The idea may become more acceptable if it is based on the recommendation of a trusted doctor. Further, constantly reassure your parent that you and other family members will remain involved in their life, and follow through on that promise.

We definitely do not recommend dropping off them for “lunch,” moving their belongings into their bedroom while they are dining and making a quick get-away. We have witnessed this approach and it always results in a great deal of emotional trauma. Residents of assisted living facilities do not give up their personal rights, and cannot be prevented from leaving if they absolutely refuse to stay there.

Respite care is an option to temporarily try assisted living. Just as a daunting task can be more manageable by breaking it down into smaller steps, respite care allows an individual to stay for a few days, or up to a month, to see if it is the right environment. In our experience, many residents want to stay longer, once they get settled in.

In other cases, the individual’s impaired mental capacity prevents them from being actively involved in the decision making. Many of the same recommendations apply for those with dementia, plus:

  • Carefully research communities and select one which has a dementia program.
  • Speak with the staff about your parent’s background and any special needs.
  • Make the move during their best time of day when they are calmest.
  • Stay positive – your attitude is infectious. Do not communicate any feelings of guilt or anxiety.
  • Provide constant reassurance that Mom or Dad is in a safe place.

 

 

Leave a comment »

Helpful Information for Seniors

A Brand New Day – Redding writes a Senior Living column for the Record Searchlight which can also be seen online at Redding.com. We talk about a wide variety of subjects with common thread about topics relevant to Seniors and their families. To follow is a compilation of last month’s posts. We hope you enjoy them.

Senior Living: How to Determine if Someone is having a Stroke and Manage Risk Factors

25 Oct 2012

According to the National Stroke Association, stroke is the fourth leading cause of death in the United States. Stroke kills 133,000 people per year and is the leading cause of long-term disability in seniors. Close to 800,000 strokes will happen this year at a rate of one every 40 seconds. Someone will lose their life to a stroke about every four minutes. (click for the entire story)

Senior Living: A Primer on Patient’s Rights in a Skilled Nursing Facility

10 Oct 2012

Don’t believe you are at the mercy of the nurses and administration when you have to spend time recovering at a skilled nursing facility. Read more for a frank Q & A about your rights.  (click for the entire story)

Senior Living: Easy Ways to Prevent Falls while Bathing

5 Sept 2012

Falls are one of the leading reasons for hospitalization among seniors in the United States. Falls result in fractured hips, ribs and bruising, all of which are painful and some require surgery, physical and-or occupational therapy. Falls can happen to the elderly quite easily and can quickly turn into a devastating event. Read more for a way to learn how to make your bathroom safer and reduce your fall risk while bathing. (click for the entire story)

We are on Facebook

If you would like to become a Facebook fan and connect to others who share your interests, please check us out on our Facebook page at ABrandNewDayRedding. Every Friday we have a PhotoTeaser, (click for the entire story)

A Brand New Day is a 26 bed Memory Care assisted living facility in Redding, CA focusing on Alzheimer’s and dementia, respite and hospice care. Our license number is 455001567. We invite you to contact us with any questions when you are concerned about the safety of a loved one at 530.223.1538. We are happy to be your Senior Care resource.

Leave a comment »

Help Yourself and Those Whom You Love by Creating a Paper Trail

This appeared over a year ago in our Senior Living Column in the Redding California Record Searchlight, yet we continue to receive requests for copies. It is a helpful reminder that we should take some time to prepare in case of an accident, emergency or illness.

If something should happen to you, would your loved ones know what to do? We are writing about this topic from the standpoint of handling your personal affairs, rather than the complexities of emotions and grieving. We also assume that you have an estate plan or will and have authorized a health care and financial power of attorney.

We often tell ourselves that someday we will get our affairs in order. But we procrastinate. When is someday? It needs to be yesterday in order for you to be prepared. Life’s emergencies just happen, and require planning to manage them. Planning requires organization, and for most of us, this is difficult to do. Don’t let this daunting task overwhelm you or put your loved ones in the difficult position of having to sort through a confusing maze. There are plenty of rainy days in a year as well as days that are too hot to spend much time outside. Use one of these days to get organized. If you spend some time organizing your important papers, you will save yourself and your loved ones a lot of trouble.

It is best to store your important papers in a safety deposit box at your bank. Then, purchase a fireproof, locked portable storage box. Make a copy of each document and store the copies, along with an extra safety deposit box key in your portable storage box. The box should be just large enough to hold your documents so that you won’t have trouble dashing out of the house with it in case of a fire, flood, earthquake or other catastrophe.

Here is a basic list of copied documents you should keep in the storage box:

  • Passport
  • Social Security card
  • Driver’s License
  • Health insurance card
  • Insurance policies
  • Your will or estate plan
  • All powers of attorney and health care proxies
  • Any certificates of investments (stock, precious metals, etc.)
  • Car titles
  • Certificates of birth, death, marriage, divorce
  • Custody documents
  • Military service documents

That doesn’t seem too difficult, does it? Now here comes the hard part — you should make a list of your assets and debts, as well as contact information of your health care providers, banker, accountant, lawyer, financial adviser, insurance agent and any professional whom you rely for care of yourself and your assets. Listing assets may be as simple as a copy of your bank, investment and retirement account statements. Note the contact person’s name and phone number if not already printed on the statement. Make a list of your credit card accounts, auto and mortgage loans. Include account numbers, due dates and lenders’ names and contact information. Write down the location of your original documents.

Next, grab your camera and take a picture (or video) of the contents of your house and garage. Video recording is preferable because you can narrate details such as when the items were purchased and the cost, details of family heirlooms and any special meaning, etc. Make two copies of the pictures and/or digital files and place a copy in your safety deposit box and the other in your locked storage box.

Include receipts for major purchases, such as a car, boat, guns, jewelry, furniture, electronics, etc.

Finally, make a list of your username and passwords to keep in the box. Store it in a very safe place and tell its location to only those who you trust to handle your affairs. Put the key in a secure place and keep a copy of the key in your safety deposit box.

Those whom you have designated to handle your financial affairs in the event of a sudden illness or death will be able to do so effectively because they will have all the information they need. You will have the ability to deal with a lost or stolen purse/wallet since you will have a copy of your driver’s license and a list of all your credit cards with the contact information to quickly notify the issuers. Your record (photographs, video files, receipts) of assets will be essential in expediting an insurance claim in the event of damage or theft.

Do yourself a favor, and follow these simple steps. You will help yourself and those who you love weather a crisis.

Leave a comment »

Be Prepared for the Future

Some people work better under the stress of a deadline. They tell themselves that they are only motivated to do their best under pressure. That may be true, but it is risky to apply that situation when seniors (and their children) have to make health care decisions in a crisis mode.

It is natural to feel uncomfortable to confront the inevitability of failing health or death with family members. Perhaps you are the daughter or son who feels it may be disrespectful to bring up the topic to Mom and Dad. Or you may be a parent and want to spare your kids from envisioning the time when you will not be strong enough to make decisions on your own.

Don’t wait for the perfect time, because there is no perfect time. Things can change suddenly, and if you don’t know your family  members’ wishes, location of documents and other vital information, it will be much more difficult to manage in a crisis situation. Discussing far-off, hypothetical scenarios are actually easier to address rather than when reality hits and you try to sort out options in the emergency room.

A good first step is to find out if there is a current will, a durable power of attorney, a health care power of attorney and an advance health care directive
(also known as a living will) in place. If not, now is the time to consult a lawyer about the purpose of each document and to understand your loved one’s options.

Exploring these legal issues will bring up many of the decisions that will need to be made. For example, your family member will need to give someone the authority to make financial and legal decisions on their behalf when completing a durable power of attorney. A health care power of attorney will require naming someone who will be responsible for medical decisions in the event of  physical or mental incapacity. An advance health care directive will provide instructions specifying what actions should be taken in the event they are no longer able to make decisions due to illness or incapacity.

Be careful about finding free forms on the Internet. While the forms may look similar to those drawn by an attorney, you can’t be sure that the “do it yourself” document will be accepted by all financial institutions and insurance companies. Additionally, different states require different criteria. Do it once, and do it correctly.

Does your family member desire aggressive medical interventions using the latest technology to battle an incurable health condition, or would they rather forego life-sustaining measures that would serve only to prolong dying? There is a document called POLST that is printed on brightly colored pink paper so it cannot be easily overlooked. POLST stands for Physician Orders for Life-Sustaining Treatment which is designed to give people more control over end of life care. The individual can detail their wishes about the degree of medical intervention they desire. It is signed by the individual and their doctor and represents a promise by all health care professionals to honor the wishes stated in the document. The POLST should accompany the documents listed above. It is not a replacement for an advance health care directive.

There are also personal preferences beyond financial and health care issues that are important to talk about. How does your family member feel about alternative living arrangements if he or she can no longer safely stay at home? If a crisis arises, who should be contacted? Do you have the names and phone numbers of their doctors, lawyer, relatives, clergy, or even friends?

These are weighty issues, and are not likely to be settled in just one conversation. It is a good idea to talk about it in person, rather than on the phone, emails or letters. Be patient and open to their responses, without bringing a hidden agenda according to what you believe is best. You may be surprised about your family member’s wishes.

Leave a comment »