Category: Managing Parent with Dementia

Elder Fraud: The Silent Epidemic

elderfraudstoryFinancial fraud is stealing $36 billion from our elders every year. So often, they don’t recognize it or they are too ashamed to tell family members for fear of repercussions. The Equifax breach is just one more in a long line of complications. One of the things you might do for yourself and your loved ones is to put a lock on your credit. When you need it, you can unlock it, so it will require an extra step … but that is GOOD!

To learn more about getting a free credit report and how to put a lock on your credit, visit this site hosted by the U.S. Federal Trade Commission. 

For those worried about loved one, I found doing things for myself first and talking about it or asking advice was one way to have a discussion with my parent’s about what might be an uncomfortable topic. When we needed to redo the Durable Power of Attorney for my parents, I first talked about who I listed and why. Even with a diagnosis of dementia, both of my parent’s were deemed to have decisional capacity by a doctor. And we could and did have a conversation about the issue and it resulted in making changes that they understood and were comfortable with.

It might be a good time to bring this up with a parent you are concerned about. After you go through the process yourself, you could suggest it for mom and/or dad, and let them know how easy it was.

The first step is to take a look at your credit report. As I recently shared, I found that accounts of my deceased mother were listed on my credit report. You never know what you might find! The next step is to consider putting a lock on your credit. It won’t protect your or your loved ones from exploitation, but anything you can do to minimize yours, and your loved ones risk, is a good thing.

To learn more about some of the scams you can watch this CNBC report. Shared. 

 

When an Independent Living Community isn’t always the Right Solution

choiceThe choices you are faced with when you are stepping in to help are many and varied. One adult child was telling me how she just got her dad to move into an independent living community and dad was still driving. She shared that he was diagnosed with Alzheimer’s so they wanted to get him somewhere and he seemed to be doing pretty well. I understand the hope to at least get them into a place that is more attuned to help, and that offers other levels of care when needed.

However, what most people don’t truly understand, or interview the community about, is how the community will be able to support the resident. The daughter was thinking “phew, we got him into the community,” but Independent Living is just that — there is no safety net. The dad was probably forgetful at home, and that won’t change, but will most likely increase after the move. Are there options to hire support for this while he is living Independently? Will he accept it?

Is it safe for him to continue driving? You would hope that his doctor would help with this issue, but in many cases, the doctor doesn’t have time to discuss it. Dad is going to need to go get groceries, will he be able to find his way safely from the new location?

When and how does the community help make sure the Dad is in the right environment.? Some communities offer day programs for people with memory loss, while others will force a move into Assisted Living.

My parents were in Assisted Living. After my dad passed away, my mom was very isolated because most of the other residents didn’t want to sit with the lady who couldn’t remember their name or that she had already ordered lunch. We ended up moving mom into a Memory Care community outside of the community she lived in because in her community most of the memory care residents were at the end stage of the disease. My mom wanted to walk and be active, but she needed cues and help getting dressed, and some one to make sure she ate.

The reality is that when there is cognitive decline, making changes earlier gives your loved one a better chance at adapting to the new environment.  You just want to make sure that it will also be the right place after the move in.

However, please recognize that you also have the option to help them stay in their home with assistance, and then find an Assisted Living or Memory Care community that is best for them as they are moving into a later stage of their disease.

Life Care communities (or Continue Care Retirement Communities) usually require a large down-payment. Will they really be able to live out there years in that community?

If you are at this juncture, I recommend finding a local Aging Life Care Manager who can help discuss the options in your area. It will save you hours of time, could save you hundreds of thousands of dollars, and help ensure you find the right community for your loved one and be prepared for the changes that will come. Experienced.

 

Some related blogs include:

We were forced by the community to move my parents.  My parents refused to move from their apartment until the community threatened to evict them from their apartment.

Making the transition to Assisted Living when your parents refuse. The process we went through to move my parents when they refused.

 

 

 

 

My deceased mom’s accounts were listed on my credit report.

creditreportexpIn the wake of the Equifax breach … which joins a long line of security breaks … I suggest you take a look at your own credit report now.

I often talk about how to help mom and dad and manage through being the adult family caregiver, and often one of the best things you can do is to lead by example.

You can get a free copy from the three major bureaus once a year, and it’s worth doing. When I recently ran my own reports, I found that my mom was listed along with some of her credit history. My mom passed away almost two years ago.

To get your report, visit: AnnualCreditReport.com 

You should not have to pay ANYTHING, so if you are being prompted to pay, you are on the wrong site. If you are just doing a check up, I would request all three. When I did this for myself recently, on the first one from Equifax, everything appeared to be in order. When I got to Experian, it provided more details and showed some accounts from my mom, who is now deceased. It also had several misspellings and listed former work addresses as former residences. It took around 45 minutes to get through the customer service system to the person that could help me. I found the same errors on the TransUnion report. They were very helpful in getting the issues corrected.

The good news is that corrections get shared with the other credit bureaus, and Experian is going to send me a note when the updates have been made and shared with the other bureaus.

In the wake of the breach, you might also consider putting a lock on your credit and recommending that to mom or dad as well. It won’t prevent the exploitation that is rampant and costs seniors $17 Billion a year, but at least it’s a start to having a positive discussion with your loved one. Hoped. 

 

What can you do when your help is not wanted?

lifesaverIn the course of a few days, I talked with two different adult children who are trying to help loved ones but being told their help is not needed. This stage is the worst in my opinion for many reasons. The first is that it is the time when changes can be made to extend the life the individual or couple wants. Cognitive issues don’t go away by ignoring them, and early action offers the most opportunities to make choices and find good solutions for continuing to enjoy life. Unfortunately, you may have to wait until there is a critical failure before you can step into help.

In both cases, the husband is caring for a wife that clearly has some form of dementia. To the husband, I believe they are trying to maintain the life they have been leading and not recognizing how much the quality of life for the spouse, or for them, has changed. First, see if you can step into the spouse’s shoes. What is it that they are afraid will change if they try to get the care their spouse will need? This is the time when they fight hardest to maintain their lives.

Please recognize that the individual with cognitive issues often don’t recognize they have a problem. It’s a medical condition called Anosognosia and what you might not be privy too is how much the husband tried to point out these issues only to create a fight with his wife. He might feel like he is keeping the peace and protecting his spouse.

If there are other adult children, can you get all them together to present a united front? Do the have good friends who might join you or neighbors they trust that have reached out with concerns? My siblings and I did this twice. Our parent’s politely declined our suggestions both times. My siblings all followed up these visits (they flew in from different parts of the country) with letters. Both my parents had cognitive issues and no short term memory, so they truly believed we were making up the issues we cited.

If you have siblings that won’t help, or encouraging your parent to ignore the feedback from the other kids, you most likely have to wait for the critical failure.

I realized that my frequent visits to stop-gap the issues my parents were having (turning back on the water, showing up to get dad off the floor on a regular basis, meeting the police when they broke into their home and called them to report a burglary) was enabling them to continue leading their lives. The decision to not show up one night and my suggestion that my mom call “911” resulted in my dad ending up in the hospital and helped us implement some better solutions for their health and safety for the time being.

If you feel they are neglecting their loved one, you might consider calling in Adult Protective Services. I would at least call them to see if they have some suggestions. Typically they are unable to help unless there is imminent danger.

The reality is most likely that the spouse feels terribly alone and has no one to talk to. They want to protect their privacy and often won’t bring this to the attention of their physicians. Most doctor’s don’t have the time to even help someone navigate a what it means to have mild cognitive impairment or dementia.

So what can you do?

  1. Listen, suggest, offer. But back off if you get no.
  2. Wait for the failure, and be ready to help when you are invited in.

I wish I had more suggestions, but sometimes you can make someone else do what you believe is right, they have to be ready. Witnessed. 

 

For some other articles related to this topic:

Sometimes you just have to be sneaky: After meeting with my parents, this is what the retirement community psychologist suggested when my parents refused to accept the help they obviously needed.

Someone broke into your house? What happened the night my parent’s call the police to report a break-in.

 

 

Loneliness and It’s Impact on our “Healthspan”

desert-lonlinessOn a personal level, the topic of loneliness has become a growing issue in my community, and not just an issue for older adults. As we move through our own life circumstances, friends come in and out of our lives. The good friendships formed when you volunteered at your kid’s elementary school grow weak when the kids end up in different middle and high schools. I have a pack of crazy tennis mates and when one was facing breast cancer and another had a knee injury, our connections grew thinner. We still work to find ways to connect off the tennis courts, but it’s harder with all the other family and work priorities. Those transitions can present real pockets of loneliness in every adult life.

I have shared my concern over the aging in place movement in prior posts. When you are no longer driving and are now living alone in your home, the impact of loneliness on your health is a very real issue.

As reported by the Village to Village network in their August newsletter Loneliness has recently been called a medical epidemic and labeled an “adverse signal” alongside hunger, thirst and pain. A growing mountain of research is linking loneliness to physical illness as well as to functional and cognitive decline. As a predictor of early death, loneliness eclipses obesity or heavy smoking and studies confirm that loneliness shortens the lifespan by 7.5 years and, even more importantly, shortens the “healthspan” even more. “Denying you feel lonely,” warns one top researcher “makes no more sense than denying you feel hunger.” Loneliness is everybody’s business.

For someone with cognitive issues, not only does the loss of short term memory make it hard to make new friends, it makes it hard to participate in a host of social activities. I am seeing this in the clients I serve. What I learned after caring for my parents is that delaying a change can actually be detrimental.

When we moved my parents from Independent to Assisted Living (at the insistence of their community which we were grateful), my parent’s were the happiest they had been in a year. Trying to managing their larger apartment and maintain their lives was too much for them. They were now closer to a host of activities and out in the community more. I was physically ill for 3 days up to the move and pleasantly surprised by my parents joy with their new, smaller apartment.

The process of the move for someone with cognitive issues typically brings a step-down in capabilities. I watched it my mom when we moved her from Assisted Living into Memory Care. However, she bounced back and had periods of joy in her new community doing a host of new activities they offered.

As the care partner you are faced with so many choices. I hope you will consider how much isolation and loneliness can have on your loved ones and really consider when it might be time to make a change. There are really MANY great options in my community now. What about yours? Wondered.

The Subtle Elder Abuse You Might Not Notice

fraudYour loved one wants to stay in their home and you are concerned. Over and over, I’m finding that even my clients who have involved adult children are victims of some subtle forms of elder abuse that is stealing away hundreds to thousands of dollars of their parent’s money.

In the past month, I’ve had a client that got taken by a face cream offer. She does not have any cognitive issues and is now caring for a loved one with Parkinson’s. She never managed the money, so she asked me to step in to help her understand and manage the cash flow and help with budgeting since the expenses are starting to escalate with her husband’s care. When we started to review the credit card, I asked her what Lye Ludermacell was. She said it was a “free” face cream trial where she paid for shipping. Well, there was more than $200 of other charges for products on her credit card. She was very angry, as have been several thousands of clients taken in by the same scam. Michelle Singletary (The Washington Post) wrote about it earlier this month. We called to cancel and recouped 75% of the charges on the products she had received. We discussed how ANY offer, no matter how credible looking that says FREE and then asks for a credit card is trouble.  Had we not looked through her credit card billing item by item, she may not have noticed for months–if even at all.  So many older adults just set the bill on auto-pay and don’t scan the monthly bills. That is a very dangerous habit when so many individuals and even organizations are working to get to your money.

A few months ago, I spent more than 45 minutes with Juno trying to cancel the service for dial-up Internet my client was still paying for. She just never thought to question the monthly $9.95 billing for Juno even though she had wifi in her house. We also found a “free shipping” subscription billing her $25 monthly she had no idea how to use or what it was. So Juno took over $1,000 of her money and the shipping subscription had been billing her for two years for more than $600 of her money. I have ten zillions ways I could spend $1,600!

The one issue that is troubling me the most is for a client with mild cognitive impairment who generally is doing fine living at home. Not only is his daughter involved, but I visit him twice a week and we have an Aging Life Care Manager Another who is helping manage his medical visits and medications. When I noticed he had a physical therapy (PT) appointment on his schedule and neither his daughter or the Aging Life Care Manager knew about it, I made a point to stop by during his next PT session at home. It turns out that six months ago, his doctor recommend PT and they had an agency come in for a few weeks. It was determined after a few visits that he didn’t need it any longer.

So here’s the dirty underbelly of health care — somehow the first company passed the order to an affiliate who called my client to say the doctor ordered PT and started scheduling both PT and Occupational Therapy appointments (medication management). When I shared what I found, his daughter quickly called to shut down the service and cancel all future appointments, but the first few visits were billed to his Medicare account. Technically, the health care agency was implementing the doctors order, but it was already determined he didn’t need the services by the first therapist.

It’s the small issues that can add up making someone with cognitive issues living alone incredibly tricky. You want them to maintain the independence and lead the life they want, but you are faced with a number of risks from safety and fraud that mean another choice might be better. Conflicted. 

 

The Cost of Aging in Place: Peace of Mind

peaceofmindI work with some older adults who continue to live in their homes. Their children are not in the area and I help manage the day-to-day finances as well as minimize their exposure to elder fraud. I get to know both my client and their children and I watch them going through many of the issues my family faced.

Recently, I got a text from the daughter of one of my clients. Her dad (who has some mild cognitive issues) told her that someone was moving in with him on the following day so he was busy getting ready for his new roommate. As you might imagine, she was a little concerned that her dad had rented out his home, and she didn’t know about it. I remember those days when your loved one is so convincing! Is it the truth or is it just something they believe to be the truth?

I found not being able to tell the fact from the fiction incredibly disconcerting. Even after my mom was living in the assisted living and there were more eyes on her, I still didn’t necessarily know if what she said about her day was true. I learned to go along with it instead of pummeling her with 20 questions.

The hardest stage of my parents care was when they were still in their home. Most people want to stay there, but as a loved one watching them wobble on their feet, miss bill payments, or sign predatory home improvement contracts, it was hard to witness, We faced all of those issues.

There are some simple things you can do and it’s relative to the health and fitness of your loved one. A few ideas for some peace of mind:

  • Challenge them with a fitbit. If you could get your loved one to wear the device, you could actually see if they are up and about and how much they are moving every day.
  • Get a fall monitor. There are pendants and wrist bands. Some you have to press a button and others have someone call you is they sense a fall. Unfortunately, if there is a head injury, no one is going to press the button, so I would opt for an option that calls you.
  • Install door alarms. Thank you Mary Smith who shared that they installed door alarms to the front and back doors so that when a door was opened, they would get a phone call.
  • Find a friendly visitor. There are many volunteer and low-cost programs that will send someone to visit your loved one in their home. It would be ideal to have someone check-in with them once a day.
  • Consider hiring a personal care assistant. The biggest issue is isolation. Hiring someone to come in and engage with your loved one can help give you a break from the daily worry.
  • Get a roommate. In my town, we are working on a homesharing program where we would match a young professional or college student with an older homeowner. Ideally, you don’t want to start this if there is a cognitive issue, but matching professionals who can’t afford to rent in our town with single homeowners who are living in 3,000 square foot homes alone seems like a win-win.
  • Contact a local daily money manager. Most of my clients are a result of a conversation with mom or dad after bills are missed or checks are bouncing because they are double-paying invoices. There are some simple ways to let mom or dad stay independent and work with someone who can help them manage the day-to-day issues.
  • Hire an Aging Life Care Manager. If there are complicated health issues or mild cognitive impairment, it will be helpful to have someone who can jump in and assist should there be an acute issue, especially if you live out of town.

On my wish list is a refrigerator monitor that can easily be added to everyone’s home. If the door isn’t opened by a time you set, you would get an alert to contact your loved one.

Are there other options out there that have given you peace of mind?  Let me know. Appreciated. 

Is Driving a Battle Worth Having? YES!

The choices you are faced with when you are stepping in to help are many and varied. One adult child was telling me how she just got her dad to move into an independent living community and dad was still driving. She shared that he was diagnosed with Alzheimer’s so they wanted to get him somewhere and he seemed to be doing pretty well. I understand the hope to at least get them into a place that is more attuned to help, and that offers other levels of care when needed.

She also mentioned that she worried about him continuing to drive. However, most of us might just accept the move as a win and move on. I know, I was in that situation. For this daughter, just getting him into the community was a victory. The next issue was going to be the driving.

You would hope that the doctor that diagnosed “Alzheimer’s” would help, but in many cases, they don’t discuss how it might impact things like driving and managing the finances.

The daughter was happy that he agreed to move out of his home and into the Life Care Community. When should she bring up the issue of driving?

According to a the National Highway Traffic Safety Administration, the youngest and oldest drivers have much higher rates of highway crashes and deaths than any other age group, according to 2008 government mileage data, the latest available. Drivers ages 16 and 17 are involved in more crashes, and fatality rates rise steeply for those older than 65, with drivers older than 80 being the most vulnerable.

Consumer Reports Dangerous Drivers 10-12

I am not sure if I’m more worried about the issue of causing a fatality, or the risk of losing all of your life savings should an older adult be sued or charged with a crime. In our litigious society, I don’t think it will be long before someone will prove that an individual diagnosed with “Alzheimer’s” or even “cognitive impairment” was reckless by making the choice to drive after a medical diagnosis.

Do you wait for the accident to happen?
As I have reiterated on this blog, when their is cognitive impairment, you often find that you have to wait for a failure. It actually has a medical term. Anosognosia is when someone is unaware of their own mental health condition or that they can’t perceive their condition accurately.  Anosognosia affects up to 81% of people with Alzheimer’s and some studies show up to 77% of patients suffer anosognosia after a stroke. So can your loved one accurately assess their driving ability? How many of us without a diagnosis over-rate some of our abilities?

Some rehab centers offer assessments, but it’s not so easy to find and in reality, who wants to go pay for a test to learn they might not be safe on the road anymore?

As the adult child, my siblings and I discussed it with our parent’s before the doctor submitted the paperwork to revoke their licenses. We were seeing a lot of dents and dings on the car that were multiplying at an alarming rate before this happened. In the end, we had to hide the cars when they continued to drive after their driving privileges were suspended by the state. I had also retrieved them a few times when they got lost driving to familiar locations. To read more about how we managed through this stage, you can read my posts from back in 2012 called Operation Safety Net.

The car keys represent freedom and independence. Most people don’t want to let that go. However, it’s a battle that is worth fighting for everyone’s safety. Believed. 

Options:

  1. Check out your local community to see if you have a Village that can provide a ride.
  2. Contact your county Agency for Aging that can refer you to discounted coupon packages or other discounted local ride services.
  3. Contact a home care agency to set up permanent rides to the grocery, mall, or drugstore.
  4. Check with neighbors or church members who might be interested and available to help out.

How to Screen Out Crooked Callers

crankcallsI often get asked how to stop the pesky telemarketing calls in my job as a daily money manager. Most of us have all put our names on the National Do Not Call Registry, but the people calling aren’t typically playing by the rules. After you register, other types of organizations may still call you, such as charities, political groups, debt collectors and surveys. If you continue to get calls after being on the list for 31 days, you can report them to the FTC here.

Unfortunately, for seniors, the biggest complaint is about the number of charities that are calling. They are exempted from the National Do Not Call Registry. If you have asked that they remove you from their call list, and they continue to call, here are a few things you can do to help stop nuisance calls:

  1. Sign up for a automated service for your landline to block calls. Nomorobo is free service I can get from my local carrier, Verizon. The Nomorobo website can help you find out if you can get their free service in your area. I implemented it at home and it has made a big difference. When we moved in 17 years ago, we opted for the unlisted number–that USED to work at keeping callers at bay. 
  2. If you can’t get a service like Nomorobo, you can purchase a call blocking device like Sentry 2 that lets you blacklist numbers. It does require that you tag calls to the “blacklist” to block, and you can also add numbers and only get calls from those on your “whitelist”. It can fill the need but does require assistance to be effective.
  3. Don’t answer the phone if you don’t recognize the number. When you answer, they know they have a valid number. Asking to be removed, or selecting the dial option they offer typically won’t yield a positive results.
  4. Sign up for “Anonymous Call Rejection” with your local carrier. It will reject calls from anyone that has blocked their caller ID information. It is usually something you can enable using *77 but varies by provider.

The DEFCON 5 OPTION

When I was in elementary school, we were getting calls at home that were personally threatening. This was in the 70’s before all the other technology options and rules existed. My parent’s put whistles by the phones, and I was told to blow it in the phone should I answer and find the person on the other end of phone is threatening me. I haven’t instituted this in my own home, but wonder if the calls would stop more quickly if we all choose the whistle option. Mischievously Wondered. 

 ** I will follow-up on what you can do if you are being pestered on your cell-phone. 

Three Common Senior Scams

checkbookI found that my parent’s were writing checks to charities on a regular basis, which was a new habit. When I realized that I didn’t recognize many of them, and then saw the amount of mail coming in doubling, the alarm bells went off.

I work with a variety of seniors. Most still live at home, have children who don’t live in the area, and need some simple help keeping track of cash flow and their bill payments. I was recently interviewed for a story on the three common senior scams and hope that you will find some tips on help to help your loved ones avoid becoming a victim to the hideous people hoping to separate them from their savings. Referred.

 

Related Stories:
– “Be on Guard: 3 Common Senior Scams” by Amy Fontinelle

Strokes and Dementia

strokeI recall the many visits to the neurologist with my mom after her stroke. We learned this was her second stroke. The doctor guessed the first one happened over a decade before but went un-reported or un-diagnosed. The second stroke began with dizziness and after watching my mom try to walk, my dad drove her right to the emergency room. The second stroke left no physical reminders, but there was a noticeable difference to my mom’s memory and how she processed information. They told me she had an ischemic stroke.

Over the six-months of visits, we really focused on understanding the cause and how to prevent a future stroke. The doctor never explained how the stroke might impact her ability to drive, manage her finances, or retain information. She also never mentioned that based on my mom’s behavior, that she probably had Vascular Dementia.

When I was talking with a client last week, he stopped me to ask why I used the term “vascular dementia” to describe his partner. She had a stroke and when I spoke with her, she had trouble getting out her words and he admitted that she had had trouble with her short-term memory. I’m not a doctor, but I shared that she seemed to present like my mom did after her stroke.

The interaction reminded me just how difficult it was to get my mom and dad diagnosed. The first neurologist for both of them never even used the term “mild cognitive impairment”, although to me and my siblings, we all recognized something was different in their behavior and thinking. Had we had an earlier diagnosis, maybe we could have developed a better plan of care to have them live with purpose and meaning for the rest of their lives.

I hope if your loved one has had a stroke, you might have more information to understand the impact and how it might shape the coming years. Every one is different, but I worry that the move to shorter medical appointments will make it even harder for the next wave of caregivers to come. Wondered.