Finding a Live-In Arrangement That Works

Most of the individuals I work with that are still in their home want to stay there. The ongoing COVID issues have made many individuals and their families second guess community care. Finding a good solution that works is harder than it might seem, but it is worth the effort.

For solo individuals with a cognitive issue the reality is that staying in their home can be more expensive than community options. It also creates a different form of stress on the family and care team as the risks of living alone create opportunities for major catastrophes. I’ve arrived and had to call 911, battled predatory vendors, and cleaned up identity theft. Had someone been in the home, the impact of these could have been minimized or even avoided.

An ideal solution seems to be having someone live in the home. Most of my clients have unused bedrooms/bath(s) that served the family when they were raising kids and enjoying early retirement. Early on, when intermittent help is needed, most do not like the assortment of personal care assistants that have come into their home to help them. However, if you don’t need more permanent home care, you often face a shifting stream of inexperienced caregivers. The experienced caregivers usually hold out and get assigned to regular and more permanent schedules. This makes it even harder to integrate care when it is needed.

I started wondering how to use the empty bedrooms effectively in the homes of client’s to benefit them. Could we find someone that could bring energy and socialization into the home, and create an intergenerational relationship that benefits both? Is there someone in your extended friends and family that could fill this role?

Most states have rules for domestic employees, which this agreement would fall under. Virginia laws encourage these arrangements. Key components of an agreement should include:

  • Creating key tasks and time needed to fulfill these duties
  • Setting an hourly rate for duties
  • Creating time off and plans for when the individual is not staying in the home
  • Finding a lawyer to put an agreement in place (most elder law attorneys can do this and you can find them here NAELA.org)
  • Rounding our insurance to cover your risks and employment law

We just implemented this solution at one of my clients and it has already been a huge relief to know that there is someone in the home on a daily basis. The ongoing engagement is also going to benefit the homeowner. The best part is that we will also have minimized the costs of care.

Here is copy of the agreement the state of Virginia offers to help put an agreement together. You can see if your state offers this resource, on your favorite browser, type in “live in caregiver agreement” and see what may find.

I am happy to get on the phone and tell you more about how we made this work. Use this option to book a time on my schedule.

I’m hopeful that this solution might work for you. Provided.

Successful Transitions and Dementia

There are many times when it feels like it is imperative to make a change for safety or financial security. However, so often those transitions are so difficult to manage most often because the individual who is impacted doesn’t recognize the change needs to be made.

Waiting is the hardest part.

I have learned that patience and perseverance win the day. After living through forced transitions and the aftermath of emotions and anger when I was living through this with my parents, I found my shift to softer and supportive worked best.

Yes, working in tandem and going at a slower pace take more time. However, imagine if you were on the other side of the equation, isn’t that what you would want?

We arrive as caregivers with a variety of different baggage. The person that is living with cognitive impairment and dementia will have a harder time changing, so the reality is that this falls to the loved ones and support around the individual.

I am working with a client now who knows she has memory issues and a dementia diagnosis, but believes that she can manage the finances just fine on her own. To help, I’m building a monthly schedule to help her and asking the friendly visitor to put due dates on the calendar to remind her to get the bills paid. We will confirm in the background that the bills she needs to pay did indeed get paid.

I work with father/daughter team and over the holidays, the dad finally resigned as Trustee. We have had to fight predatory home service companies and this summer walked in to find a hacker had control of his computer and was starting to transfer money out of his bank account. Thankfully we stopped it in time, but then we spent nearly six months cleaning up the aftermath of the account and credit freezes we put into place. However, his daughter respected how much this meant to him and never pushed him. Over the course of the past two years, she has gently and kindly reminded him of the issues and on this visit, he finally agreed it was time to make the transition.

I know everyone doesn’t have the support and resources that some of my clients have, but I believe there are still ways to reconsider the threat and find ways to support your loved. Got an issue? I’m happy to help. Sending an email to me at Info@MemoryBanc.com. Supported.

Start the LTC Claim ASAP

In working with individuals who have Long Term Care (LTC) Insurance, I have one of our many who used it all up. Sadly, I have walked into situations where the individual has passed away before they used half of the benefits.

Initiate your claim as soon as you qualify.

I am still waiting to figure out why you wouldn’t start your claim as soon as you possibly can. What you should know is that:

  • Once your claim is approved, you NO LONGER PAY your LTC premiums.
  • While many state they are for two years, that is how they calculated the full benefits, but they continue to pay as long as your policy still has money left to cover your LTC qualifying expenses.

If it were me, I would rather use up all of the LTC insurance money before I paid for the services needed out of pocket.

Many of the policies have a distinct mention of cognitive impairment which is separate and distinct from qualification by needed help with the Activities of Daily Living (ADLs) to include bathing, walking, toileting, dressing, and eating.

I hope this might spur a few people to look into this and get the benefits flowing as soon as you or a loved one qualify. Hoped.

The Link between Dementia and Mismanaged Finances

Eureka! What I recognized anecdotally for years is now published research that concluded financial symptoms of cognitive issues are surfacing up to six years before a formal clinical diagnosis.

SIX YEARS.

You are noticing changes in your own thinking, or you are seeing changes in a loved one that is concerning, but the primary care doctor just reassures you that you are “fine.” I witnessed this all play out with my parents for years. By the time we finally had a formal diagnosis, both of my parents were diagnosed with MODERATE forms of dementia. Dad they believed to be Alzheimer’s and my mother had primarily Vascular Dementia.

If you are having more difficulty with bill pay and managing the checkbook balance, it is time to share that with a loved one and your primary care physician.

Many financial mistakes were made for many years preceding this, including the decision to stop paying for long-term care insurance. Most of my Dad’s retirement accounts were unattended and forgotten.

For more insight into this visit this Washington Post Story.

After living the journey with my parents, and now supporting individuals and families as a daily money manager, I have seen and cleaned up many of these issues. It is rewarding, but sometimes takes my breath away, when I calculate how much money was wasted or lost over the years that could have been used to help pay for their care.

The research primary looked at payment delinquency. If someone is missing bill payments, when they were prompt payers before, this change could be a sign of a cognitive issue.

If you are experiencing this, or are having trouble making your checkbook balance when that has been a lifelong habit, it’s time to share this with a loved one as well as your primary care doctor.

The earlier you identify an issue, the more options and control you can have over it’s future course. Believed.

Just say NO to Memory Supplements

While we all hope there is a quick fix to memory or cognitive issues, Consumer Reports confirmed that “By avoiding memory supplements, consumers can both save money and avoid unnecessary health risks.” You can learn more in this recent Washington Post story.

If you are noticing issues, the place to start is with your Primary Care Doctor. Are you taking drugs that might be impacting your memory and recall? Are there other factors that could be contributing to what you are noticing?

If you see your Primary Care Doctor, and are not satisfied with the recommendation or response, get a second opinion. I watched as my parent’s had issues that went unaddressed for years. It was frustrating to know something was wrong, but have their doctor’s just dismiss concerns.

Yes, it could have made a difference. If diagnosed early, individuals can be involved in planning for their future instead of us having to make our best guess on choices that had to be made for them. It was during the time we knew something was wrong that they also decided to stop paying for the long-term care insurance they been paying for nearly two decades. They have since required policy holders to designate a reporting contact so this doesn’t happen to others.

While my parents thought they had thoroughly planned everything, plans need to change when health and key members of your plans are unable to fulfill their obligations. So often spouses assume their spouse will be able to speak for them. In our case, both parents failed simultaneously. Other families report the spouse is in denial and sadly the result is the same.

I encourage you to be diligent in helping find a provider who can help you if you are noticing changes in your memory, or for a loved one if you are seeing changes in thinking and behavior.

My brother in law sent me a link to a website with resources by Biogen called CatchItEarly. They share while Alzheimer’s disease is usually diagnosed in people 65 and older, it starts earlier with subtle neurological changes occurring years or even decades before symptoms appear.  Many people are experiencing early, often unrecognized, signs of mild cognitive impairment and this site offers educational resources about the signs and resources for several drugs in clinical trials.

We still don’t have a cure, but hope the information provided is helpful to you and your family. Recommended.

Managing Through the COVID Lockdowns

The community where one of my clients has been living happily for over a year, sent me a note about new cases found and the process they were going to take to test everyone. This morning I learn that my client is one of 17 residents who tested positive today and my heart breaks. My colleague was going to visit because we have noticed she has been a little down lately.

No wonder. Many of us have seen the report that isolation is as harmful to us as smoking a pack of cigarettes’ a day. Forbes just shared the grim statistics of community residents across the county. “90 percent said they never left their campus, 60 percent said they never even went outside their building to take a walk, and more than half said they had no access to any activities within their facilities.”

In the beginning, we noticed that the forced lock-down actually benefited “Susan” because she was finally meeting and spending time with the other residents. However, when they went into full lockdown, where they have to stay in their rooms ALL DAY LONG, and eat their meals alone in their rooms, we can hear the sadness in her voice when we call.

This time I am going to start a silly postcard campaign so that she is at least getting a note and knowing that we miss her. We are all calling her too. Her family doesn’t live nearby so phone calls help. However, nothing is worse than being sick alone … AND too sick to even answer the phone.

My hope is that this former teacher will enjoy some silly postcards. Are there other ways to stay connected with someone who doesn’t use a computer, a smart phone, and for now, is too sick to talk on the phone.?

I sure hope that she ends up with a mild case. While she is in her 80s, she has very few other pre-existing conditions besides mild-cognitive impairment.

Please send me a note if you have any other ideas on how best to help those isolated during quarantine, and even worse, all alone as they fight COVID. Asked.

A Quick Way to Ensure You are Well-Represented

When my parents health started to fail, I was the adult child that was local and stepped up to help. While my parents had planned well, what I needed was information on their accounts, the locations of their personal documents, and access to their online accounts to help reset codes and update account information.

While I wrote a book that will walk you through this process, I am happy to give you a summary of what you need to collect and organize so you can do it yourself. Having a summary of this will help your spouse, partner, and loved ones that will step in to help should you need it.

Every adult should have a Durable Power of Attorney. It gives someone the ability to step in for you and pay bills, and manage your financial affairs if you are unable to do this — even temporarily. We did this for my son when he turned 18, and I used it to file his taxes one year when he was traveling.

For those of you caring for someone, you know how important, frustrating, and necessary it is to have this document in place. What many people don’t know is how difficult and time-consuming it can be to have a financial institution recognize the document. Many couples don’t realize until, it is a problem, that being married does not give you instant access to a spouse’s account if you are not named on it.

In hopes of giving you a simple guide to organize this information for yourself, I am releasing this free download.

Get a free copy of this guide at http://www.MemoryBanc.com/POA

Feel free to share it with everyone you love. Offered.

Strokes, Free Will, and Frustration For All

I am working for a gentleman who had a stroke. He is challenging every tool I have as well as frustrating his family who is very concerned for his safety and fiscal well-being. It’s hard to help someone that can’t recognize they need the help. While he saves up the mail and is happy to have us manage his bills and medical claims, he is taking cash out of his ATM regularly and has no recollection of where his cash went.

He left the rehab facility after his stroke and returned home where all daily living rules have changed. His habit of eating out could no longer be met. The doctor told him he should not drive, yet he is driving all over. His friend is bringing in meals for the two of them and now he is spending way beyond his means but has no awareness of money management.

I walked into this account while he was in rehab to find he was already $70,000 in debt and no longer had any credit on either of his cards.

The family members are beyond frustrated. I fully understand. You try to help and then your loved ones undo all the help you layered in not recognizing or appreciated the help. Then they usually get mad at you for butting into their lives.

A caregiver is coming in daily to help, but “Mike” keeps getting in his car and driving around. He doesn’t understand the need for social/physical distancing. He also doesn’t believe that he needs to stop driving. The doctor told him he had to go to the DMV to get assessed and put in a request to suspend his license. He still has a license with a valid date in his wallet and is continuing to drive. That is the biggest challenge – what are some options to stop the unlicensed driving?

When my parents were driving on suspended licenses, I quickly ensured that we first followed the need that caused the driving. Do they need groceries? Do they need to get to a medical appointment and aren’t used to calling cabs?

Once we knew those basic needs were met and this was more about control and freedom than need:

  1. I made sure they had umbrella insurance. If they were in an accident, my guess is that their auto insurance would not cover them since they were driving on suspended licenses.
  2. I calmly conveyed the possible consequences that they could harm themselves or others (they poo-pooed this idea); that their insurance didn’t cover uninsured drivers and an accident could consume their savings (they pulled out a valid license … they had torn up the notes from DMV suspending their licenses and requiring they turn in the driver’s licenses); that they could be taken to jail.
  3. We unplugged the starter (a neighbor helped to reconnect it after they told them what their horrible children were doing to them).
  4. My brothers came into town to help once things got REALLY bad and hid their cars. This is the one that finally worked.

Some other suggestions from other care managers include:

  • Offer to schedule defensive driving lessons. There are specialists that work with individuals who have lost their license and help coach positive skills behind the wheel.
  • Call the local police and see if they will visit the driver and offer a friendly warning. One family that did this put a boot on the car following the visit from the police.

The balance of free will and safety with love and family dynamics can make all of this so frustrating. I hope some of those suggested might help you. Experienced.

Guilt: The Hidden Emotion carried by Adult Family Caregivers

For those of us caring for or having cared for a loved one (dementia or major health issues that require you as the family member to step up and advocate), we know that guilt is a constant companion and lingering emotion long past death. What could I have done better, different? Why didn’t I do X, even though Mom made me in clear she wanted Y?

Since I help with the day-to-day finances, home upkeep and am often named as the Power of Attorney and Trustee, I am finding I’m very sensitive to the language used by other professionals on the care team. While I am not involved in managing the home care or medical choices, I am usually copied on the discussions about the medical needs since they usually impact the finances.

I still have crazy dreams every once in a while where I have failed to visit my Mom in her memory care community. It’s almost been five years since she had her heavenly departure, but I guess these are similar to the dreams I used to have where I forgot to show up for my final college exams.

If you serve in a capacity as a:

  • Friendly visitor
  • Care Manager
  • Financial Advisor
  • Personal Care Assistant

Please recognize that the adult family caregiver is already grieving, probably feels the constant companion of guilt for NOT being involved enough, and focus on sending positive reports and using the care team in place to manage those things that need addressing that you can resolve without the family caregiver. Of course you should absolutely speak up if you feel the individual is in danger or could harm someone.

What I believe after living this journey with my parents is that “You don’t know what you don’t know” — which is perfectly OK. However, if you have not ever lived as an adult caregiver, recognize that the person that is living this journey, what you share with them matters and I hope you will just consider that filter when you send them updates on visits with their loved ones. Suggested.

Dreamwork Makes the Care Team Work

Caregiving was already hard, but I feel like Covid and the isolation has made things twice as difficult. I hope you are all managing to adapt and have resources and options to help best serve those you are caring for now.

So many things seem to go wrong and fall through the cracks. I have two clients that are alone in their homes and the effort and care of the team is the only way they can safely stay in their homes. These clients are lucky to have the money to afford these resources. I don’t think most people really understand that aging in place brings with it different costs that can be as much (and even more) than a care community.

I’m lucky to have passionate individuals on these care teams that contribute insight and truly care about how we can best serve their needs.

My Aging in Place Dream Team includes:

  • Aging Life Care Manager: Someone needs to be the lead on medical appointments, follow-ups and health care needs. I tried to manage all of this for my parents and wish I had brought them in sooner than her last year to help. I regret the lost time managing her health care needs when I visited her memory care community versus just being able to sit and spend time with her as a daughter.
  • Friendly Visitor: There are a variety of individuals who are able to engage, help, and guide through hobbies, shopping, and setting up and helping with Zoom calls to socially distant friends and family.
  • Home Care Team: Whether it is an individual or an agency with a deep bench, having someone that can help with the activities of daily living as well as ensure they are safe in their home 24/7 has been a necessity.
  • Daily Money Manager: Someone to pay the bills and manage the home maintenance.

In the past two months, we have experienced an Identity Theft (he gave his banking information to someone that he thought was Apple Support even through he has a Dell); a flooded apartment; phone service outage; a failed car inspection (he has a car that family can use when visiting that was his wife’s and is important to him); yard care needs (this rain has really helped the kudzu grow).

There are many handoffs and follow ups needed to keep the team in synch. We share a digital calendar for one client and the other one has 24/7 in-home care that updates the schedule of visitors.

For both clients we have talked about having them live in a care community. Right now it’s a hard transition with required 14-day isolation and difficult to decide to move someone into a care community where we know Covid wreaked havoc. We recognize that we are the ones helping them lead their lives in spite of all the Covid barriers.

The reality is that you will make the best choice with the information you have. I just realized how much I valued the team of individuals helping support these individuals in their homes lead the lives they had planned. While we are all feeling so isolated lately, I am happy to be part of these thoughtful care teams. Appreciated.

What is the Right Deci$ion for Mom and Dad’s Care?

For those podcast fans, please check out Rodger That a weekly podcast focused on the caregiver. Here, skilled caregivers, Bobbi and Mike Carducci offer their personal and practical insights on caring for a loved one with dementia, as well as tips to help caregivers prioritize their own emotional and mental well-being.

Bobbi & Mike interviewed me on how caregiving can be emotionally & physically challenging, but also a rewarding, selfless act. However, it shouldn’t come at the expense of your financial health & well-being.

We discussed a few things I learned as the adult family caregiver for two parents for 5 years, as well as have used to help dozens of families as a Daily Money Manager in the metro-DC area. #Honored.