Tag: caring for someone with dementia

Brush, Floss, and Visit the Dentist Regularly – Friday the 13th Healthy Habit

lifeisbetterwithteeth

If you don’t know, oral health has a link to your general health. You can get a deeper dive on the topic and the related health conditions from Mayo Clinic.

There are many reasons why brushing and flossing are healthy habits, but it’s also important to see your dentist regularly.  They may catch oral cancers early when they can be more easily treated. While my father had Alzheimer’s, a tumor at the base of his tongue is what ultimately took his life. I had tried many times to get him to the dentist before we knew about the tumor,  but he just refused. In reflection, I wonder if somehow he knew. He had always been a good dental patient before the diagnosis.

If you are caring for someone with cognitive issues, be kind to yourself if they just refuse. In some ways it maybe the one way they feel control over their lives.

As difficult as it was to see my Dad’s physical pain and suffering the last month of his life, I also feel he was blessed to get to take a celestial departure before he lost more of himself.

The habits we develop and maintain can carry us and help us maintain good health. I often have to remind myself of that when I’m waiting for my tooth brush timer to end. Brushed.

Make copies of everything in your Wallet: Healthy Habit 10

wallet

Should your wallet ever get lost or stolen, having copies of everything that was in it will minimize your stress. It will save you a lot of time when you need to call to cancel credit cards and follow up to request replacements of medical or insurance cards.

It will help if you make notes on the credit cards in your wallet that are set up for auto-payments for other services. A few things you should know about this:

  • Some credit card companies will ask that you pay for charges made on a lost card if you never called to report it missing. When they added the chip to our credit cards, they now have the ability to know if the credit card was physically used. If your card is not in your possession, but you did not report it missing, the credit card company fairly has the right to hold you liable for those charges.
  • Many larger vendors have dozen’s of 800 numbers linked to the specific credit card account. If you have a copy your card you have quick access to the direct number to report the card lost/stolen as well as the identifying information they may request from you about your card.

If you are incapacitated when your wallet is missing, this gives your loved ones an easy way to step in and help you.

Recently, I had a client whose wallet was stolen while he was in the hospital. Unfortunately, I had not made a copy of everything in his wallet and had to wait until he was well enough to talk through and figure out what he was carrying in his wallet.

It’s now one of the first things I do when I work with a new client now. Warned.

Follow the Science on How Brains Age – Healthy Habit #2

followthescience

I wanted to understand how I could perhaps better recognize, prepare, and hopefully avoid the fate of my parent’s who both were diagnosed with different forms of dementia. One of the best things I did was to go through the Total Brain Health Certification. I met the founder Dr. Cynthia Green when we both appeared on The Dr. Oz Show.  Her book Total Memory Workout is a great primer on simple ways to maintain brain health and boost your memory.

The reality is that the common belief that “forgetfulness” is a normal sign of aging is false. Our brain processing slows down usually starting in our 50’s but the inability to recall information or short-term memory loss are signs of disease, not a typical reality of aging. But A LOT of people believe it and tell themselves it is normal.

If you understand how your brain ages, as well as how some of the changes in our brains actually make us MORE trusting (and why older adults are easier targets for fraud), you will be better able to plan and put systems in place to safely live well.

If you start to notice changes, you can then talk with your doctor. There are many things you can do if you catch issues early and some of them are entirely reversible.

If you have a loved one who is showing signs of memory loss, I hope you will raise the issue with them. I certainly tried with my parents. My Dad was open to pursue testing and investigate while my Mom shut down the idea that something was amiss. It took several years and many doctors before we found someone who would help us understand what was happening to our parents. Unfortunately, it was too late to do anything … and maybe there was nothing to be done. However, it would have helped if we could have talked through their wishes knowing a diagnosis of memory loss was made.

In the case of your brain health, knowing will afford you a lot more options. Recommended.

Here are a few articles to get you started:

Age-Associated Financial Vulnerability: An Emerging Public Health Issue Annals of Internal Medicine Annals of Internal Medicine – December 1, 2015

Supplements for Brain Health Show No Benefit – a Neurologist Explains a New Study The National Interest – June 28, 2019

Why It’s Easier to Scam the Elderly NPR – December 6, 2012

Healthy Aging Habit 1 – Use ONE Calendar

calendar

Having more than one primary calendar will get you into trouble. I have a book that I carry during my work day and sits next to my computer that is my “master” calendar. I sync it up at least every Sunday with my digital calendar that is shared with my family and coworkers. When I’m out and someone asks to schedule something, I can quickly check it on the digital calendar I can access from my phone (if I don’t have my book calendar with me).

I’ve always had a paper system. I like to take notes and also use my “master” paper calendar as a To-Do List. Some people may use only digital, others only paper. Just make sure you have ONE MASTER Calendar.

I watched my parents and now my clients that have more than one paper calendar. They invariably double book or miss appointments because its difficult to manage appointments consistently in two paper versions.

If you are assisting a loved one, I recommend getting them a small format desk calendar (11×17) that can sit in the kitchen. Not only does it offer more space to write down information, but it’s too big to get picked up and moved. Here is a link to the one I have given to a few clients – it’s attractive and offers space to list important phone numbers and key tasks for the month.

I don’t recommend the wall calendars because they aren’t easy to use. Invariably, they get taken down to write down appointments and seem to move around the living space instead of being kept on the wall.

My favorite planner for the past few years is the Action Day Planner.  Please check out the different formats and sizes, there are quite a few.

No matter what you chose, I just hope you will find a format that works for you. Experienced.

** Please shop around. I don’t get any incentives or kickbacks on these links – I’m just sharing some suggestions that have worked well for me and my clients. 

Difficult People and Dementia

see through boxers

When I hear the statistics about older adults living with dementia, I immediately dismiss them because I believe they are just too low. I know there are many people living with dementia that were never diagnosed and so they have never been counted.

I understand why families choose not to pursue testing. However, I also know that there are so many factors that could contribute to create symptoms of dementia that some might be living with it needlessly.

There are a host of drugs that can alone or in tandem with other drugs may imitate dementia (The Washington Post).

I recently was involved with a family who were very concerned about their father. He was explained to me as a “very difficult person.” As I met with him and the woman who helps him out regularly, it was very clear to me that he had some form of cognitive issue. However, all of those around him are just chalking up his behavior as a personality quirk. The family confirms that he did not always behave in this manner, but over the years he has got more ‘difficult’.

As I was talking with him about how I could help with some of the daily money management issues it was clear he did not comprehend where some of his income was coming from — some was from military service and had been coming to him for over 60 years. There were several small things that demonstrated to me he was having trouble comprehending and processing the information. The fact that he has been unable to pay or manage his day-to-day finances is a big clue. So often I am called after there has been a financial boo-boo that was too glaring to ignore any longer. Ideally, you don’t want to strip them of their control, but just layer in some help.

My final clue was that when I met him, he was in his boxer shorts. He lives in a high-rise complex and was down in the lobby talking to a neighbor when I arrived. As we return to his apartment, I find that I can see right through his mesh boxers to skin. I mentioned this to the woman who is helping him on a regular basis and she confirms that she will ask him to put on a second pair before they leave for lunch. He is intelligent and curious, and as a man in his 90’s, I don’t think he recognized that he is walking around in public in his underwear.

I recognize all of the reasoning we used in my family. You want to respect and honor an individual, but often, it seems to reach the point of failing to possibly address the source of the behavior changes. Maybe they are caused by medication or even hearing loss (you don’t understand what you don’t hear.) For a variety of reasons, I ask that if you find yourself in this position, you advocate to get some medical attention to eliminate possible causes for the change. Suggested. 

According to the World Health Organization: “Dementia is a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation.”

Giving Back the Checkbook

You know the feeling of helplessness when you don’t have any cash in your pocket and the thing you want requires cash? Well imagine if your loved ones took away your ability to buy things when you feel like you are making good choices.

In my job as a Daily Money Manager, I work for individuals who have usually been diagnosed with mild cognitive impairment or even a specific form of dementia. Usually, at the request of a family member they call and invite me to come meet. They don’t understand why the family is concerned.

I start by asking them how they feel things are going. The response is usually more of “I am managing” and then they usually confess they know they have made “a few over/under payments.” I explain how my job is to help them feel confident in their bill payments and cash flow management. Ultimately, I work to help them feel empowered by continuing to pay bills together.

If I see there is a big concern over exposure to fraud or predatory service providers, I will set up a new checking account. It allows the individual to have a checkbook but the amount of money that is at risk is limited to the money in the account. NOTE: Do not set up overdraft protection but allow the checks to bounce.

A second option is the TrueLink Card. It is basically a funded gift card that you can apply protections to like turning off the ability to charge fees for jewelry, liquor, or phone charges (there are over 20 categories you can tweak). You can see what has been purchased. It does have some complications and limitations as I have seen. One client has had the card fail when he was trying to buy a watch battery (deemed as jewelry) as well as was not able to get his favorite local cheese at the Farmer’s Market because they were using a portable pay device (deemed as a phone charge). I have been able to customize the options and pre-approve that favorite cheese vendor, but when he is at the market, he needs the card to work and it doesn’t always.

At the end of the day, what we want is for our loved one to have meaning and purpose and often, taking away the money can strip them of some independence they deserve.

Is there a way for you to give back that power to a loved one and help them regain a sense of self? Hoped.

How often is a Doctor Available?

As the primary family care partner for my Mom, I was often taking her to a variety of medical appointments. While both of the communities she lived in had visiting doctors, they usually were unable to see her in a timely manner or did not have the type of expertise needed. For instance, after a fall sent my mom to the Emergency Room with a goose egg sized lump on her forehead, we were told we would need to schedule a visit to an Ear/Nose/Throat specialist. For that we needed to travel to a local provider.

A story in The New York Times, Where There’s Rarely a Doctor in the House: Assisted Living, dove into this topic and it is worth reading if you are in the process of looking at a community.

Getting to medical care can be both a time and monetary issue to manage for loved ones that are not addressed by many Assisted Living Communities.

The current communities are having to adapt to the changing demographics and health issues. Most of the Life Care Communities planned on having their residents span a few decades and start moving in when they were in their 60s.

Today, the average resident is over 85 and 70 percent of them have some form of cognitive issue. The community did not plan for their residents being unable to manage their own medical care needs due to cognitive issues. On top of that, there is a cost to get the resident to a doctor in both terms of staff time and transportation. In the metro-DC area, a trip to the doctor for just the transportation averages $110 and this is for individuals who can walk.

When you are visiting, be sure to ask how they deal with the minor health issues like a cold or flu. Do they have regular visits by a doctor and how often? What types of doctors visit? Most communities are going to be unable to handle these issues but it’s better to know before you have an issue than learn about the advocacy and transportation needs after you have made the move. While you may still need to leave to get to a specialist, it is helpful to know they have a robust option for on-site medical care for many of the minor issues that may faced a loved one. Advised.

P.S. Ask to speak with the families of other residents and ask them to share how they have found the doctor. One reader reminded me that you may need to verify what the community sales person tells you.

Named a Best Alzheimer’s Blog 2019 by Healthline

It’s nice to get recognition. For a fourth year, Healthline has selected Dealing With Dementia one of the Best Alzheimer’s Blogs. I started this blog for many reasons. One was to provide my siblings with insight into the issues I was facing as the only adult child living near my parents. But then it became a way for me to digest what was happening and dissect how I was dealing with it. I have lots of “mea culpa” blog posts. Turns out I finally figured out I learn by doing and I made a lot of mistakes.

Since I’m not one to miss a golden opportunity, I will use this to remind the readers that Alzheimer’s is just one of the five primary types of dementia’s — as shown in the image. It is the most common based on the number of diagnosed cases, but I also know that many individuals are never diagnosed.

Its been more than two years since I cared for a family member with dementia. Today I work with a variety of individuals and families who have been diagnosed and continue to learn how to be a better care partner.

For a full list of the winners, You can visit Healthline. I am honored to be recognized again for this honor. Encouraged.