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If you or a loved one is struggling with the challenges that come with memory loss, join Malka Young, LICSW and other elder experts for this free 5 week interactive series designed to educated and connect people living with Alzheimer’s and related dementia and their care partners to one another and resources. Space is limited – call (508) 532-5980 ext.4108 and register today.

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To take the best care of your older parents,
Turn to the pros for help

Baby Boomers were once called the Me Generation, but now they’re defined less by Me and more by We — the family universe of aging parents, adult children and often grandchildren, nieces and nephews. For most Boomers, the most pressing concerns are usually for older loved ones, whose needs grow more complex with each year.

Add a fall, a major illness or concerns about increasing forgetfulness, and it can be overwhelming.

Making decisions about what to do, how and when, isn’t easy. Lifelong patterns are hard to change; we’re used to our parents making their own decisions, just as we make ours. It’s hard to intervene when you are not sure whether it is really necessary.  Family members often disagree about what should be done and by whom. And indecision or procrastination can intensify physical and emotional issues.

How hard can it be to find quality help, to find a good doctor, or to know which rehab is best? If you turn to the Internet for help, you’ll find that search engine results can be misleading, confusing, overwhelming or all three. It may come as a big surprise to people who are confident about sourcing information for work, or are skilled at Internet research, when they can’t seem to find the right information on their own.

Consider these typical scenarios:

  • You visit your mother in the morning and she is standing at the stove cooking a steak, a stack of unpaid bills on the kitchen table and prescription bottles mixed together in a bag along with a few unlabeled bottles containing an assortment of different colored pills. She assures you that she knows exactly what and when to take, but it doesn’t seem likely.  Putting help into the house for four hours a day of home care should help, but as the parent’s functioning deteriorates, four hours becomes eight, then possibly more.  Eventually the family is paying $100,000 a year for non-professional help.
  • It seems as if an assisted living is the next step, so you call that number you see advertised on TV and tell the “advisor” about your mom. Your advisor takes your personal information and the next thing you know you are inundated by calls and 3rd class mail touting senior living.
  • After the last fall, your father spent three days in the hospital and you are informed that he wasn’t really admitted, that he was under observation and that if he goes to rehab he will have to pay out of pocket. Didn’t he go to rehab last time he fell?
  • Your parents thought their AARP membership card was a Medicare Part D prescription drug plan and you find out there are penalties and higher premiums forever—and anyway they can’t sign up for another couple of months and even then the plan doesn’t go into effect until next year. Your parents continued with the same insurance company that provided their health insurance when they were working. How could they know that their doctor wasn’t in the network now that they were on Medicare?

What a care manager can do

Yes, handling these issues is difficult and emotionally charged.  What—actually who—can ease the way is a geriatric care manager sometimes called an “aging life care” expert.   These are certified professionals, often social workers or nurses, who understand older adults, our health system, and the complex web of resources, both public and private  that support health and well being.  Care managers also offer advice and support when it’s time to make important decisions about short- and long-term care, whether at home or in a facility.

Here’s what you need to know:

  • When you hire an elder care expert, you want to make sure that they are your advocate and that they have a fiduciary relationship with the older adult. They work independently from hospital, rehab and residential facilities, and do not accept commissions or referral fees. They work on a straight consulting agreement, typically by the hour.
  • They know about the gaps and pitfalls you’ll likely encounter, and they know how to navigate continuity of care.
  • They are especially helpful when family members don’t live near the patient, when family members don’t agree on a course of action, or when there is some sort of transition, either from living independently to living in an assisted living facility; from hospital to rehab to home; from home to hospice; from driving to not driving; from walking with a cane to a wheelchair or even going from no help to some help at home.
  • Investing a few dollars upfront can save you thousands of dollars of mistaken choices, misunderstood benefits, or lack of awareness of special programs that exist to support older adults aging in place in their own home.
  • They are well versed in the intricacies of Medicare and Medicaid, and know what can be outsourced and what only family members can do.

Still on the fence about hiring an elder care expert? Most families hire specialists to help with tax prep, college admissions and career moves.  Hiring a professional to help with an aging parent is just as worthwhile.

Malka Young is a Licensed Independent Clinical Social Worker and a Certified Care Manager. Email her at myoung@jfsmw.org.

 

Need assistance taking care of older parents? We can help.

Contact us through the online form or call 800-655-9553
for a free phone consultation to learn how Allies in Aging
can help you navigate the challenges that come with aging.

Click to read what our clients are saying about Allies in Aging – JFS Elder Care Solutions

 
         About the Author

Malka Young, LICSW, CCM

– Director of Allies in Aging JFS Elder Care Solutions
– Advanced Professional Member of the Aging Life Care Association (ALCA)
-Certified Care Manager

Malka Young and her multi-disciplinary team provide a full range of life care management services for older adults and their families. With over 40 years experience they support families and elders in the community, in hospitals, nursing homes, rehabilitation centers, hospices, assisted living residences and at home.
Specialties:
– Customized Plans & Assessments
– Short & Long Term Planning
– Guidance with Housing Options
– Care Coordination
– Discharge Planning
– Advocacy & Monitoring
– Family support
Contact Malka today to learn how JFS Elder Care Solutions 
can help your loved ones live better, longer.
Phone: 800-655-9553
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Planning for the Future after a Diagnosis of Dementia

So much of the focus on aging well is on the medical aspects— physical symptoms, testing and treatments—that we often overlook other practical factors.


Some forgetfulness can be a normal part of aging, and it’s often not mentioned during doctors’ visits until the memory loss reaches alarming levels.

Initially, the doctor may be full of reassurance, which will help with everyone’s anxiety—temporarily, anyway. Doctors are under pressure not to make referrals to specialists unless they are sure it adds value to the quality of care. And because there is no cure for dementia, their approach is often: let’s not make it more stressful for the patient and their family, since there’s little that can be done medically. This approach does not recognize that a lot can be done legally, emotionally, psychologically and financially, to prepare for what lies ahead. A lot can go wrong both for the patient and their loved ones, during the months and years before the dementia is recognized and acknowledged.

 

The need for thoughtful planning

Even if someone with mild cognitive impairment passes a screening test, it doesn’t mean they can take their medicine as prescribed, safely drive a car or know if the leftovers in the refrigerator are still edible. It’s also not unusual for someone with cognitive impairment to make foolish or irrational financial moves—opening credit card accounts, signing contracts (for a second mortgage or unsecured loans, for example) without fully understanding terms, or falling prey to scam artists or pushy or unethical salespeople. It’s sad when your banker suspects dementia before your doctor does.

Getting an early diagnosis is essential. It allows you to control the things you can control even though you may be powerless to change the progression of the disease. It gives you and your loved ones the time to consider decisions in a deliberate, thoughtful way, avoiding common mistakes before a patient’s problem-solving skills deteriorate and irrevocable actions are taken.

 

Why an early diagnosis of dementia is so important

Having an early diagnosis allows a person to:

Designate a health care proxy. This person will make medical decisions on behalf of the person with dementia (PWD), based on clear instructions made while the PWD is still of sound mind. He or she can, for example, decide where they prefer to receive care, whether or not to be treated with chemotherapy for cancer, or go on dialysis.

Designate a durable power of attorney. This person can fulfill the PWD’s legal wishes when they’re unable to communicate or are incapable of rational decision-making. The ability to sign a contract on the PWD’s behalf, whether it’s for setting up companion services at home, arranging care for a pet, or selling a car, gives everyone peace of mind.

Determine living arrangements. Family members may think that a person with dementia should be in a particular setting, whether at home, in assisted living, nursing home or somewhere else. This isn’t necessarily the case. Knowing what a person’s preferences are, what they value and what is most important to them makes it easier to confront hard choices.

Set up spending controls. Before the dementia progresses, it’s important to have a plan for handing control of assets to a trusted person, whether, friend, family member or professional financial advisor or estate planner. It’s better to anticipate that there may come a time that a PWD will need others to manage their money than to wait until there is a financial mishap and try to repair the damage after the fact.

Other considerations
Also know that these arrangements aren’t about solely about the patient.

  • If a PWD is your health care proxy, you need to designate someone else to be your proxy—sooner rather than later.
  • You many need to assume a role you’ve never had in your relationship before. Many couples split the day-to-day tasks of managing their family, whether it’s keeping track of birthdays, maintaining the social calendar, paying bills, planning meals or fixing things around the house. A PWD’s ability to fulfill customary roles will change, and it’s crucial to rethink those roles and figure out a way for these necessary tasks to get done.
  • Rethink the timing of celebrations and vacations. Having a 47th anniversary party instead of waiting for your 50th, taking your cruise to Alaska this year instead of next year, or deciding to put the next generation in charge of planning holiday celebrations are all reasonable things to do if a loved one has just been diagnosed with dementia.
  • Plan for the little things, too. It’s not unusual for the person with early dementia, while they still can, make special plans beyond estate planning and healthcare. We know of one gentleman, when told he had early dementia, contacted his local florist and arranged for weekly flower delivery to his wife, continuing a tradition that began after they got married 55 years earlier. This loving act helped sustain her through the long years of caregiving that followed.
  • Recognize that dementia not only erases personal memories, but also the location of bank accounts, retirement funds, tax records and many other important financial documents. Find out where these items are, whether the will is updated, and the locations of account passwords and safe deposit box keys.
  • Make arrangements for bill paying, grocery shopping, cleaning, repairs and yard work.

These kinds of proactive moves can be difficult, even painful, to face. But waiting to confront these issues can cause a lot more pain down the road. It’s best for to begin the contingency planning early.

Need help with a loved one with dementia? We can help.

Contact us through the online form or call 800-655-9553
for a free phone consultation to learn how Allies in Aging
can help you navigate the challenges of living with dementia.

 

Click to read what our clients are saying about Allies in Aging – JFS Elder Care Solutions

About the Author:

Malka Young, LICSW, CCM
Director, Allies in Aging JFS Elder Care Solutions

 

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