Tag: dementia and confusion

Simple Ways to Protect Finances.

While likely under-reported, the National Council on Aging estimates elder financial abuse and fraud costs to older Americans range from $2.9 billion to $36.5 billion annually. Older American’s that have been abused have a 300% higher risk of death when compared to those who have not been mistreated.

After caring for two parents with dementia, I remind myself how much the checkbook meant to my mother. She had always managed the household finances and pointing out to her that she was failing to manage the finances was something that needed to be left unsaid. If you are concerned, first work with the person to support their efforts before suggesting they hand over the checkbook and finances. Some easy ways to help may be:

  • Create a monthly schedule of bills and maintenance due dates
  • Log in to the banking websites and credit card sites to monitor spending and confirm no fraudulent or suspicious transactions and fill in the bill pay gaps
  • Set up a checking account they can use that has a minimal balance to keep in their purse or wallet for writing checks and use a different account for bill pay needs

My mother kept losing her purse that included her checkbook. So dealing with that was very time consuming. My Dad recognized this and took me to the bank to set up a new checking account for my Mom. We funded it as she needed money but no longer had to worry that the account that received their retirement funds and paid for the mortgage was at risk. We automated many of the home bills (mortgage, utilities) and I would monitor the spending behind the scenes.

Utimately, I wanted to help but not be invasive or diminish my parent’s ability to manage their finances.

Some other tools to consider include:

  • Get a tile and insert it into the wallet so you can easily find it if it get’s misplaced. You can use their online portal to track it’s location.  
  • Set up a TrueLink card. It is basically a pre-funded credit card where you can set up limits on how much can be charged as well as products and services that it won’t fund. There is a fee for it, but the small expense is worth the money it will most likely save in potential losses.

If you have a variety of personal care assistants coming into the home, or your loved one is in a community, I hope you will consider some of these options.

I have worked with families both at home and living in communities that have been a victim of caregiver exploitation. One got my client to write her a small check, one purchased some face cream for my client and asked her for repayment of $85, and another apparently kept asking for gas money. Most agencies and communities require their caregivers agree to never accept money or gifts from clients. Should a client give them money, it needs to be reported to the community or agency. In one month, I had to report three caregivers for violating this condition of employment. Sadly, I know they will just turn up at another agency.

Managing the finances for many may be one of the few remaining freedoms that offer a sense of control. Some are giving up car keys, volunteer activities they love, hobbies they can no longer maintain and the checkbook can offer an empowered sense of self.

If you have been diagnosed, or are a family member and unable to do this for your loved one, you can contact a Daily Money Manager who can fill this roll.

With billions at risk, take some time to ensure someone is minding the finances. I hope these options help you and your loved ones. Suggested.

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

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.”

Shining through a dementia diagnosis

A recent photography contest awarded three winners for their self-portraits. All of the contestants have dementia or Alzheimer’s and was organized by the Bob and Diane Fund.

demenitaphotowinner
Elia Luciani’s self-portrait from a mirror on a dresser covered with family photographs. (Elia Luciani). Please make sure to check out the photo behind Elia in her self portrait.

As I poured over the image, I immediately broke into a laugh when I saw the portrait she has hanging on the wall behind her. Not only is family an obvious piece of the photographers sense of self, but I have to assume that is her with her hands above her head making a silly face in a similarly set-up self portrait by someone else … maybe even a husband.

I savored the moments when my gracious mother shined through her dementia. There were days when she immediately knew me and would talk about the family, or reflect on what my dad would have said if he were still alive about something fantastic in my life that I shared with her. She wasn’t able to ever perceive her cognitive loss, but just knew that “her brain was bad.” I missed her terribly when she was alive, and that loss carries on with me now that she is gone.

I hope you will take the time to view the winners and honorable mentions. It’s inspiring to see how many are living with, adapting and shining brightly after their diagnosis of dementia or Alzheimer’s. Awed.

When our memories fail us.

As I was caring for two parents who had different types of dementia, I started to second guess my own memories. I started to worry that I was already failing cognitively and then I started to notice how often within my own household we would have conflicting memories of an event we had shared. It made me feel better … and worse.

Apparently, many emotional memories we are convinced we remember, turn out to change over time. In a story that ran in The New Yorker titled You Have No Idea What Happened by Maria Konnikova, it’s interesting to learn how our memories fail us … yet how sure we are that our memories are vividly correct.

simpsonchase

As I write this on the 25th anniversary of O.J. Simpson’s famous drive in a white Bronco, my husband asks me if I remember where I was eating. I immediately know where I was. It is a major restaurant chain that I haven’t entered since this night … but it had nothing to do with that car chase.  I’m looking forward to finding out how different my memory is from my hubby’s.

The research shows that “the strength of the central memory seems to make us confident of all of the details when we should only be confident of a few.”  In one study, they actually ask the participants how confident they were of their recall of memories they had recorded two years previously. Five was the highest level and they averaged a 4.17. However, “their memories were vivid, clear—and wrong. There was no relationship at all between confidence and accuracy.” Worse was that when they were told they were mistaken — they just didn’t buy it.

Knowing how fragile memory can be has made me much more sensitive to how it feels to have your ability to remember challenged. No one wants to hear their memory is bad, but we all need to recognize that sometimes our recall may fail us.

As a reminder, memory loss is not a normal consequence of aging. And apparently we all have problems remembering “flashbulb” emotional events in our lives. Humbled.  

Lying to the ones we love.

Two things that should be a part of every caregiver bootcamp:

  1. An introduction to the medical reality that our loved ones may not be able to recognize that they are having cognitive issues. It’s called Anosognosia and if someone in your life has had a stroke, or been diagnosed with dementia it is something you should understand. The individual is not purposefully dismissing you as I thought of my mother. I assumed she knew something was wrong but decided to ignore it and dismiss my concerns. However, the reality is that most likely she really had no idea that she was failing cognitively. One report cited that a “categorical diagnosis of anosognosia was made in 42% of patients with mild AD” (Alzheimer’s Dementia). Another report cited that over 80% of those diagnosed with varied dementia had anosognosia.
  2. There are times when honesty is painful for everyone when a loved one has dementia. When my mom wondered when Dad was coming home from the hospital, I initially walked her through his death and how we were all surrounding him. I still puddle at the memory of these conversations and it’s been more than five years since I had them with Mom. She relived the pain as did I. Why didn’t I just say that he would be home in a few days? I had a fixed belief that honesty was the best policy … but there were many times when it didn’t serve my Mom.

I wish I had learned and understood this much earlier in my journey as a family caregiver. It will take some time to understand and adapt. However, being armed with this information can help you be a better care partner.

When I finally learned this information and how to apply it, I promised myself that I would tell the truth once and after the initial conversation would find a kinder way to respond to Mom’s questions or demands.

Once I learned how to change, life for both of us got better. Shared.