Elder Law Firm of Steve Bailey

Does Alzheimer's Run in Your Family? Take These Six Steps Now to Protect Yourself

“These six tips might help you avoid the development of Alzheimer’s disease or slow its progress if you have symptoms.”

The experts agree – they do not yet know for sure what causes Alzheimer’s disease, the most common form of dementia. They have a good idea of a genetic connection in one percent of the cases, but for the other 99 percent, the researchers are looking at a wide range of possible causes or contributing factors. Since they do not yet know the causes of Alzheimer’s, it is difficult for people to understand how to prevent it.  However, the scientists offer some suggestions. Does Alzheimer’s run in your family? Take these six steps now to protect yourself.

What Lifestyle Habits Might Help You to Avoid Alzheimer’s Disease?

The researchers feel somewhat confident about these three tips, which should come as no surprise:

1. Get plenty of sleep. Your brain clears amyloid from your brain when you sleep, and there is a link between amyloid production and Alzheimer’s. Dr. Marshall, a Harvard-affiliated Alzheimer’s researcher, suggests a target of seven or eight hours every night.
2. Move around. Dr. Marshall says that people with symptoms of Alzheimer’s can slow the disease’s progress and people without it, can prevent it from developing through physical exercise. Do not worry; do not turn your schedule upside-down or become a gym rat. Just get moderately vigorous aerobic exercise for about half an hour a few times a week. A brisk walk is a good option that does not require you to buy any equipment or pay membership fees.
3. Eat delicious food – of the Mediterranean variety. Even adding just a few elements of this way of eating can make a difference. A Mediterranean eating plan includes lots of fresh vegetables and fruits, with whole grains, olive oil, and legumes. For protein, you would focus on fish and nuts, with poultry, eggs, and dairy in moderation and little red meat. And red wine in moderation.

Although they cannot say with as much certainty these next three tips will help you avoid the development or progression of Alzheimer’s, the scientists have evidence these lifestyle choices may be beneficial:

4. Be a social butterfly. Okay, do not go that far. However, you should not be a hermit. Observational studies hint at a connection between increased social interaction and avoiding Alzheimer’s. Your local senior center or community center should have multiple options for activities. Check with your city’s parks and recreation department for additional senior programs.
5. To drink or not to drink? Some studies show that one drink a day for women and one or two a day for men can reduce your risk of developing Alzheimer’s. Some studies challenge this conclusion. Dr. Marshall suggests that if you drink, do so in moderation.
6. Give your brain new toys. If you stop learning new things, your brain can suffer a decline in cognitive function. The more variety of new and different brain games, the better. Do the crossword puzzle every day or play bridge or read the newspaper, those are great for your brain, but throw your gray cells a curve ball now and then.
   
   If you always read novels, for example, now and then read a memoir or biography of someone who interests you. Listen to a different genre of music now and then. Try cooking a new cuisine. See a foreign-language film with subtitles. Get involved in activities with people from other age groups.

Having a healthy lifestyle can help you enjoy your golden years to the fullest. These six tips might help you avoid the development of Alzheimer’s disease or slow its progress if you have symptoms. To learn what you should do to protect yourself legally and financially during your retirement, talk with an elder law attorney in your area.

References:

Harvard Medical School. “What can you do to avoid Alzheimer’s disease?” (accessed March 21, 2018) https://www.health.harvard.edu/alzheimers-and-dementia/what-can-you-do-to-avoid-alzheimers-disease

Alzheimer’s Association. “Prevention and Risk of Alzheimer’s and Dementia.” (accessed March 21, 2018) https://www.alz.org/research/science/alzheimers_prevention_and_risk.asp

How to Pay for the Costs of Care for Alzheimer’s or Other Dementia

“To a certain extent, your financial options for paying for the expenses of dementia will depend on the age of your loved one and whether he is still working.”

After the reality sinks in that your loved one does, in fact, have Alzheimer’s or some other form of dementia, you discover that you now have more to think about than the diagnosis. It may have taken several years to get the diagnosis, while you worried about the well-being of your aging relative. Now that you know what your family is facing, the practical concerns kick in, and you need to develop a strategy for dealing with this situation. One of your primary questions is how to pay for the costs of care for Alzheimer’s or other dementia.

Having a loved one with a significant special need, like Alzheimer’s or another form of dementia, can be life-changing. You need to make sure someone is watching out for her twenty-four hours a day, seven days a week. If you have a huge family nearby, you might be able to take shifts for a while.  However, in time you will likely need to hire outside help or assist your loved one to move into residential care. Your loved one with dementia will face many other expenses. Here are some of the typical expenses for a person with dementia:

• In-home care, which can involve meal preparation, grooming, household chores, medical treatments, medication management and wellness/safety supervision.
• Home modifications for the safety and comfort of the senior with dementia.
• Drugs for the management of dementia and any other medical issues.
• Tracking devices and monthly monitoring fees can be a true lifesaver for finding a dementia patient who has wandered away from home or residential care.
• Inpatient treatment for short-term medical needs.
• Long-term care, ideally in a residential memory-care facility.

How to Pay for These Costs

To a certain extent, your financial options for paying for the expenses of dementia will depend on the age of your loved one and whether he is still working. Some people in the early stages of dementia manage to maintain employment. Here are six sources of funding for the expenses that can accompany dementia:

1. Insurance. If your loved one is age 65 or older, Medicare may pick up some of her medical expenses for dementia care. If she is still working and under 65, her group employee health plan is an option. If she is under 65 but does not have group employee health insurance, check to see if she has a private health insurance plan.
2. Employee benefits. People who are still working might have a menu of employee benefits that can help cover some expenses of dementia. Check with the human resources or employee benefits department about your loved one’s eligibility for paid sick leave or short-term disability benefits. A flexible spending account can also pay for some costs.
3. Retirement benefits. If your loved one is retired, check to see what retirement benefits she can use. There may be more than one of these retirement accounts: IRAs, annuities, 401(k)s, 403(b)s, and pensions.
4. Personal assets. Some items might not have outside sources of funding. For these things, your loved one might have to spend personal assets.
5. Government assistance. In addition to Medicare, many other public programs can assist with income, long-term care expenses, and other costs. If your loved one is under 65, Social Security Disability Insurance (SSDI) might send him a monthly check. Check to see if he qualifies for Supplemental Security Income (SSI), Medicaid, or veterans’ benefits. Sometimes a family member can get paid for serving as a caregiver for your loved one.
6. Community support services. Local community organizations can offer free or low-cost home-delivered meals, transportation, support groups, respite care, and other services for your loved one and her family. Check with your local Alzheimer’s Association chapter or use the association’s Community Resource Finder to locate services in your area.

Every state has different laws and programs, so be sure to talk with an elder law attorney near you.

References:

Alzheimer’s Association. “Community Resource Finder.” (accessed February 16, 2018) https://www.communityresourcefinder.org/

Alzheimer’s Association. “Paying for Care.” (accessed February 16, 2018) https://www.alz.org/care/alzheimers-dementia-costs-paying-for-care.asp#insurance

Who Gets to Decide Where My Father, Who Suffers from Dementia, Lives?

“If you are confident that your dad needs to move into assisted care, you have several options.”

If you are facing the heartbreaking situation of having a parent with dementia, you are probably  very concerned about his care and safety. You want to make sure he is getting the care he needs, and you worry about his living conditions. If he is not willing to consider moving into an assisted living facility, you may be asking, who gets to decide where my father, who suffers from dementia, lives?

First Things First

A diagnosis of dementia does not necessarily mean he must immediately move out of his home. Go with him to his next doctor’s appointment and ask his doctor if he must move into an assisted living or memory care facility. Be aware, however, that even if he can live at home safely now, you do not know when the disease will progress, and he will wander off, accidentally set the house on fire, or forget to eat. If you are confident that your dad must move into assisted care, you have several options.

Talk with Him

Do not assume that your father will oppose living in a care facility. For all you know, he is scared, too. He may be torn between his fear of his vulnerability and his pride in feeling he does not need help.

If he is still physically fit, he may genuinely feel he need not go into a care facility. This mindset is understandable, since his generation thinks of assisted living centers only as places for people who are feeble and bedridden.

Family can try to gently convince him that a care facility is in his best interests. If the family is not unified in this opinion, however, you must deal with a new set of problems.

How to Include Your Parent in the Process of Finding a Care Facility

Find assisted living centers with memory care expertise, then take him there to visit and look around. He may be envisioning “old school” nursing homes that were bleak and depressing. When he sees how the facilities for the aging have evolved, he may be pleasantly surprised and stop resisting the move. When you find several places that will meet his needs, have him choose the one where he will live. This tactic will let him retain some control over his life and preserve his dignity.

If Your Parent Continues to Resist Assisted Living

Ideally, one of the tactics discussed above will work. If your dad continues to oppose the move, check his legal documents to see if he gave anyone authority to act on his behalf. If he has a durable power of attorney or a medical power of attorney, you or someone else close to him might decide for him.  However, you should have an elder law attorney read the document to make sure that it covers your situation.

Social services might help. Contact your local senior services agency to see if they will perform an evaluation. In certain situations, they can step in and facilitate the move.  Once they are involved, you and your father will lose control and independence.

In a desperate situation, you might have to take your dad to the emergency room for an involuntary psychiatric evaluation. The hospital may transfer him to a geriatric/psychiatric hospital that can develop a care and treatment plan.

For a long-term solution, you might have to go to court and get a guardianship. This process is expensive and can take months, but you might get an emergency guardianship pending the permanent guardianship. You should not try to get a guardianship without the help of an attorney.

The laws that apply to seniors are different in every state. Talk with a local elder care attorney to formulate the best plan for your parent.

References:

Alzheimer’s Association. “Telling a Person That They Need Long-Term Nursing Home Care – Care Consultation.” (accessed December 27, 2017) https://www.alz.org/maryland/documents/telling_a_person_that_they_need_long_term_care.pdf

Challenges for Caregivers Dealing with Alzheimer’s

 “The stress of serving as a caregiver for a dementia patient can create issues that you might not anticipate, unless you have walked this path.”

Taking care of a loved one who suffers from Alzheimer’s disease can take a physical and mental toll on you. It is easy to get overwhelmed and to experience burn-out. The stress of serving as a caregiver for a dementia patient can create issues you might not anticipate, unless you have walked this path. There will also be behavior changes that can throw you for a loop, if you are not prepared. If you are a caregiver, you must know the challenges for caregivers dealing with Alzheimer’s.

The Rules Are Different Now

Alzheimer’s is a vicious disease that can change the person you may have known for decades into someone whose behavior you barely recognize. It is vital that you do not get upset and that you try to understand why she is doing the things she is. If you are rigid and inflexible with a dementia patient, you will just frustrate both of you. You must be nimble and flexible.

You will not convince her she must do things your way, so arguing is pointless. If she is unkind or hurtful, try to realize that it is the disease, and that she does not mean it personally. Try to accept who she is now.

Reasons a Person with Alzheimer’s Will Behave Differently

Imagine not recognizing the people around you, the faces of your loved ones, or where you are. A person with dementia might behave in an extreme manner in this terrifying situation. If he struggles to communicate, he might get frantic trying to get his point across, then get frustrated or angry when you do not understand him. Eventually, he might give up and withdraw out of a sense of hopelessness.

Although he has been making his morning coffee and walking the dog for many years, the ravages of Alzheimer’s might render him no longer able to complete these tasks. Losing his abilities can make him depressed or irritable. He might be cranky to those around him, because his environment is too loud or busy, or he might be hurting or uncomfortable because of illness. His medications might make him feel groggy, nauseous, or lightheaded.

Try to sort out the roots of his non-preferred actions, so you can help him be more comfortable. Think of your role as supporting and facilitating him to have the best day he can.

Make Sure to Take Care of Yourself

You cannot take good care of your loved one, if you are about to crack under the stress. Everyone gets fatigued, but here are some signs you need to take a breather and let someone else step in for a while so you can get rest and respite:

• You become short-tempered, blaming the patient for not doing things correctly.
• You feel hopeless and depressed, and lose interest in things you used to enjoy.
• You have difficulty sleeping out of worry she will wander off or get hurt.
• You deny the reality and insist that the dementia is temporary.
• Your physical and emotional exhaustion cause you to miss appointments and cannot concentrate on things in the rest of your life.

Serving as a caregiver for a person with Alzheimer’s is a thankless job that takes a team. You should not try to shoulder the entire load yourself. If you are helping with the patient’s legal planning, talk with an elder law attorney near you, because the laws are different in every state, and this posting is about the general law.

References:

OnHealth. “Alzheimer’s Disease: Caregiving Challenges.” (accessed January 21, 2018) https://www.onhealth.com/content/1/alzheimers_disease_caregiving_challenges

Alzheimer’s Association. “Caregiver Stress.” (accessed January 21, 2018) https://www.alz.org/care/alzheimers-dementia-caregiver-stress-burnout.asp

What to do When Your Elderly Loved One Signs a Contract with Diminished Capacity

 “You have just found out that your older relative has signed a contract, and you want to take action.”

You worry about your aging loved ones and fear that others will try to take advantage of them financially. Sometimes the people who rip off our seniors are strangers, but they are often friends, relatives, neighbors, caregivers or other trusted individuals. You have just discovered that your older relative has signed a contract, and you want to take action. Here is what to do when your elderly loved one signs a contract with diminished capacity.

Evaluate Whether Your Loved One Had Enough Capacity to Enter into the Contract

Determining whether someone has legal capacity, is far more complicated than it initially seems.

Age alone cannot rob someone of capacity. There are people over 100 years old still sharp and able to sign binding legal documents. There are also people 30 or 50 without capacity.

Having a particular medical diagnosis does not, in a vacuum, negate capacity. A person can have a diagnosis of bipolar disorder, paranoid schizophrenia, dementia, or some other condition, and still be able to sign binding documents when in a “lucid interval.” The challenge is to prove the state of mind, when the person signed the document.

The law also imposes differing standards of capacity for different situations. The capacity to marry, vote, drive a car, serve in the military, make a will and stand trial when charged with a crime, all have their own yardsticks to measure capacity. According to the American Bar Association, the definition of diminished capacity changes depending on the transaction under discussion. A person might can decide what to buy at the grocery store but not have the capacity to sign the documents involved in selling his house.

Standards for Capacity to Enter into a Contract

Here are some of the different standards for contractual capacity:

• For general contracts, the courts will explore whether the senior understood the business deal she was engaging in and the nature of the contractual act and how it would affect her. Business transactions highly complex, require a greater level of understanding by the senior.
• Real estate contracts usually have the same standard for capacity as general contracts.
• In some states, creating a durable power of attorney requires the same level of capacity as a general contract, but in other states, the bar is set at the capacity to make a will.
• The standard for testamentary capacity (making a will or trust), you must know who your heirs are and others to whom you would likely leave your assets, know of what property you have and how much you have, and be able to merge these concepts into a rational donative plan.

Steps to Take If Your Loved One Signed a Contract When Lacking Capacity

If your loved one lacked capacity when signing a contract, you can challenge the contract. The first steps can be informal, such as contacting the other parties to the contract in writing to challenge the contract on the grounds of lack of capacity and advising them to cancel the contract.  However, if your loved one is in imminent danger of financial loss, you may need to contact law enforcement or your local prosecuting attorney, also called a district attorney.

You can consult with your local office on aging and adult protective services and request they investigate and take action. You can also hire an attorney to write demand letters to the other parties and sue asking the judge for a declaratory judgment that finds the contract null and void.

Every state has unique laws, and this posting discusses the general law. Talk with a local elder law attorney.

References:

American Bar Association and American Psychological Association. “Assessment of Older Adults with Diminished Capacity.” (accessed January 17, 2018) https://www.apa.org/pi/aging/resources/guides/diminished-capacity.pdf

Senior Care Advice. “Can People with “Diminished Capacity” Make Legal Documents?” (accessed January 17, 2018) https://seniorcareadvice.com/can-people-with-diminished-capacity-make-legal-documents.htm

Tackling the Legal Issues Associated with Caring for a Parent with Dementia

“Your parent can sign several legal documents that will protect him and handle his legal issues. These documents include a durable power of attorney for health care decisions, a durable power of attorney for financial matters and a will or living trust.”

When caring for a parent with Alzheimer’s or some other form of dementia, it is easy to be overwhelmed with anxiety over the constant daily issues of her medical care and making sure that she does not wander off or accidentally set the house on fire while cooking. There is, however, another concern you should address for your parent, and that is tackling the legal issues associated with caring for a parent with dementia.

An adult suffering from dementia is vulnerable to physical harm and financial exploitation from others. He can do things that expose himself and others to danger and can create legal liability that could risk his assets. You can do nothing and hope for the best, or you can be proactive and protect your parent through the savvy use of legal documents.

When Your Parent is Still Legally Competent

If your parent still has the legal capacity to sign legal documents, it is much easier and less expensive to address her issues. The conversation with your parent may not be the most comfortable talk you have ever had, but it is necessary. You can explain that by preparing the documents now, your parent controls her outcome, rather than later asking a court to enter an order.

Your parent can sign several legal documents that will protect him and handle his legal issues. These documents include a durable power of attorney for health care decisions, a durable power of attorney for financial matters and a will and/or living trust.

A durable power of attorney for health care decisions will designate someone to make medical decisions for your parent when she cannot speak for herself or make appropriate health care choices. This document should name someone your parent trusts to make medical and life-or-death choices, including life support, resuscitation, feeding tubes and hydration. Your parent should have a candid conversation with the designated decision-maker to make her wishes and convictions known. She can change or revoke this document at any time, as long as she is competent.

With a durable power of attorney for financial matters, someone can manage your parent’s business and financial affairs for him. The power of attorney should be durable; otherwise, it will expire when your parent loses legal capacity. He can change or revoke this document at any time if he is legally competent.

Your parent must make a will and/or living trust while she is still legally competent, because she cannot make a valid will once she becomes incompetent. Both a will and a living trust allow her to decide who will inherit which items from her, but a living trust can also designate a trustee who can manage her financial and business matters, while she is still alive. The living trust can specify that the trustee’s authority will continue, in the event of your parent’s incapacity or death.

What to Do If Your Parent Is No Longer Competent

If your parent has lost legal capacity due to dementia or other health issues and he did not prepare the documents discussed above while he was competent, you may need to get a guardianship and conservatorship over him. A guardianship lets you take care of his daily needs, such as where he lives and the medical care he receives. A conservatorship empowers you to take care of his financial matters.

The court must declare him incompetent before it can grant a guardianship or conservatorship. These legal actions are expensive and can take several months or longer. It is better to get his documents completed, while he still has legal capacity.

This posting discusses the general law, and the law in your state can vary. Talk with an elder law attorney in your area.

References:

Alzheimer’s Association. “Planning Ahead.” (accessed November 16, 2017) https://www.alz.org/care/alzheimers-dementia-financial-legal-planning.asp

Money. “5 Essential Documents for Protecting a Loved One with Dementia.” (accessed November 16, 2017) http://time.com/money/4127552/dementia-care-legal-documents-need/

FindLaw. “Legal Issues: Caring for Parents with Dementia.” (accessed November 16, 2017) http://elder.findlaw.com/elder-care-law/legal-issues-caring-for-parents-with-dementia.html

What to Look for in a Memory Care Facility

“There are no consistent standards for memory care communities.  Therefore, you have to do the reconnaissance work yourself. The three most important issues you should explore are the facility, your loved one, and the money.”

It is tough to watch your loved one go down the path of Alzheimer’s or another form of dementia. You want to make sure that she is safe and protected, yet treated with compassion and respect. If you are looking for the right fit for your loved one, it helps to know what to look for in a memory care facility.

There are no consistent standards for memory care communities.  Therefore, you must do the reconnaissance work yourself. The three most important issues you should explore are the facility, your loved one and the money.

How to Check Out the Facility

Staff. The team should love their work. They should be there because they want to be, not because they could not get a job anywhere else. The facility should ensure that the staff is well-trained. The center should perform in-depth background checks before hiring an applicant. When you do drop-by visits, notice whether the staff interact with individual residents and engage them in activities, or whether they treat the residents as a group, which can be dehumanizing.

There should be at least one full-time staff member for every five memory care patients. If the ratios are higher, with more patients to each employee, they can only crowd control, not mindful nurturing. When memory care facilities are understaffed, the staff can become short-tempered, and the residents’ quality of life suffers. Understaffed facilities use more psychotropic medications to restrain the residents chemically. They may also just park residents in front of the television. In these environments, the mental status of the patient deteriorates, and her dementia worsens.

The physical structure. Dementia patients must be able to move around freely. A savvy architect will design a memory care facility with a circular hallway and secure, protected outdoor space to accommodate this need. In a traditional nursing home layout of dead-end hallways, dementia patients are more likely to wander away from the facility.

The community should be easy to navigate, with icons and user-friendly visual cues. There should be a visual cue at the entry to each resident’s room to help him find his place. Each resident’s room should be personalized, to reduce the “institutional” feel. Photographs and memory boxes can provide happiness and comfort to the patients.

The facility should be clean and organized. It is helpful to visit several times on different days of the week and different times of the day and night. Go to the center when they do not expect you, to see what happens when they think no one is looking. There should be no odors, unpleasant smells or “cover-up” aromas.

How to Evaluate Your Loved One’s Needs and Wishes

Needs. Your loved one must be safe and secure, but should not feel as if he lives in a fortress. He needs activities to keep him physically fit and mentally alert. When you visit the facility, make sure it will meet these requirements.

Wants. Some people prefer to spend their time with others of a similar cognitive level. Talk with your loved one to see if this is an issue. Facilities have varying levels of privacy and personal space. Remember this, so you will choose a center that will be a good fit.

Financial Considerations When Selecting a Memory Care Facility

Memory care facilities usually cost more than standard nursing homes. Ask if the facility accepts Medicaid. If it does not, your loved one might have to move if she exhausts her funds. Transitions can be more traumatic for people with dementia, so it is best to locate a facility where she can remain, regardless of finances.

Your state may have different regulations that govern memory care facilities. Because the laws are unique in every state and are constantly evolving, talk with an elder law attorney in your state.

References:

Alzheimers.net. “Questions to Ask When Exploring Memory Care Options.” (accessed September 6, 2017) http://www.alzheimers.net/2014-04-24/questions-to-ask-about-memory-care/

AgingCare.com. “Questions to Ask When Choosing a Memory Care Facility.” (accessed September 6, 2017) https://www.agingcare.com/articles/questions-to-ask-when-choosing-a-memory-care-facility-190140.htm

Kiplinger. “How to Choose a Memory Care Unit.” (accessed September 6, 2017) http://www.kiplinger.com/article/retirement/T027-C000-S004-how-to-choose-a-memory-care-unit.html

 

 

Caring for Parents with Dementia

“Every person’s dementia is unique, but there are many common behaviors associated with the condition. You need to be aware of these actions and have a plan for how to deal with them.”

When your parent has dementia, you have limited options. You can try to find supports that will allow him to continue living at home, or you can find an assisted living center or nursing home appropriate for dementia patients. Your parent’s safety is the paramount concern, but consider his feelings and give him a voice . One of the most challenging things an adult child can experience is caring for parents with dementia.

Eight common behaviors of dementia, and tips for how to handle them

Every person’s dementia is unique, but many common behaviors are associated with the condition. You must know of these actions and have a plan for how to deal with them.

1. Paranoia: It hurts when your aging parent accuses you of stealing things from him. It is upsetting when he thinks that the FBI has bugged his house. Paranoia is a frequent visitor to people suffering from dementia. Try not to take it personally. Be reassuring and comforting. Do not argue.
2. Adequate nutrition and hydration: Dementia can cause a person to forget that she must eat or drink. This behavior can cause weight loss, malnutrition and dehydration. It can help to have meals at consistent times every day. Finger foods and sippy cups can make it easier for your parent to self-feed and drink. Eating with your parent can encourage her to eat.
3. Wandering: When a person with dementia wanders, it can quickly become a tragedy. Regular physical activity can reduce your parent’s compulsion to go walking alone. Install a home security or monitoring system, and put new locks at other locations on doors. Keep tracking devices in his watch, belt, jacket or shoes. Obtain and prepare a “scent kit” so tracking dogs can locate him within minutes.
4. Agitation: Keeping your parent’s life structured and predictable , will minimize her anxiety. Treat her with respect. Let her have as much independence as safety will allow.
5. Sleeplessness/Sundowning: Dementia can wreak havoc on a person’s “body clock,” making him more active at night than during the day. If he gets regular physical exercise and fresh air and avoids naps during the day, it can be easier for him to unwind at night. Keep sugar and caffeine out of his evening meals. Establish a regular, calming evening and bedtime routine.
6. Incontinence: As if dementia did not rob people of enough dignity, it also can cause your parent to lose bladder or bowel control. You may need to post signs with images that help her find the bathroom. Have her use the bathroom at regular intervals. Have commodes available if she has trouble getting to the toilet in time. Provide clothing with elastic waistbands or Velcro fasteners. Have her wear incontinence pads or disposable underwear.
7. Perseveration (repetitive speech or actions): If your parent repeats words or actions often, he may be perseverating. Telling him to stop is pointless, and can agitate him. This may increase his perseveration. Divert his attention with an activity he enjoys. You cannot stop him from perseverating entirely, so be prepared to accept a certain amount.
8. Bathing: As her dementia progresses, your parent may forget how to bathe. Provide her the supports she needs, while respecting her privacy. Do not leave her unattended in the bath or shower. Safeguard her modesty by keeping her covered with a towel in the shower or tub.

Every state has different laws, so talk with a local elder law attorney to get advice on how to protect and care for your aging parents.

References:

Family Caregiver Alliance. “Caregiver’s Guide to Understanding Dementia Behaviors.” (accessed August 8, 2017) https://www.caregiver.org/caregivers-guide-understanding-dementia-behaviors

A Place for Mom. “Dementia Care Dos & Don’ts: Dealing with Dementia Behavior Problems.” (accessed August 8, 2017) http://www.aplaceformom.com/blog/2013-02-08-dealing-with-dementia-behavior/

AARP. “Caring for a Parent With Dementia.” (accessed August 8, 2017) http://www.aarp.org/home-family/caregiving/info-09-2012/caring-for-a-parent-with-dementia.html

What to Do When Your Elderly Loved One Goes Missing

Your aging parent is living with you. He has become a little confused lately, but you shrug it off as normal aging. You worry about whether he is developing Alzheimer’s disease or dementia, but you do not want to think about that for long. Then, one day when you come home from work, he is not there. You suddenly must know what to do, when your elderly loved one goes missing.

Call 911

According to AARP, if you have searched your house and yard unsuccessfully for 15 minutes, call 911. Time is of the essence when a senior goes missing. The Alzheimer’s Association reports that as many as half of the people with dementia or Alzheimer’s disease who wander, will experience serious injury or death if not found within 24 hours. Exposure to extreme cold, extreme heat or dehydration can be lethal to a wandering senior. There is also the risk of drowning.  Knowing what to do when your aging loved one wanders off, can save his life.

Get neighbors and friends to help search

You need as many people as possible as quickly as possible to help search.  Therefore, reach out at once to the people in your neighborhood for help. They know the area and are likely to recognize your loved one. Know that your loved one may hide from the searchers. If he finds his way home and sees emergency vehicles there, he may wander off again out of fear.

Have a plan

More than half of the people with Alzheimer’s or dementia will wander at some point, and many do so repeatedly. Since wandering is a frequent occurrence with the elderly, have an action plan. It is much better to plot out the steps to take, before you are in a crisis.

How to create an action plan for when your elderly loved one goes missing

According to NBC News, some states participate in Silver Alerts, an Amber Alert-like program for missing seniors. Alabama uses Silver Alerts.

Have your loved one wear a tracking bracelet, and consider placing a GPS chip or other tracking device in his watch and shoes. If your loved one is suffering from cognitive issues, he may remove one item.  Therefore, it is essential to have multiple devices in place. Tracking devices can cut the search time down to minutes, instead of hours. Pinpointing your loved one’s location quickly, can save his life. This is especially important, if he is wandering near a body of water.

Prepare flyers with color photos of your loved one, her physical description and your contact information. This information will help search volunteers and law enforcement who do not know your loved one. Have your loved one’s fingerprints available for law enforcement.

An ounce of prevention is worth a pound of cure.

If you have reason to believe your aging loved one is likely to wander due to Alzheimer’s disease or dementia, it is time to consider moving her into assisted living. This decision is for her safety.

Every state addresses elder law issues differently. Please consult an elder law attorney in Alabama about how to best care for your aging loved one.

References:

National Elder Law Foundation. “Silver Alert: What to do when a Senior goes Missing.” (accessed July 5, 2017) http://www.nelf.org/silver-alert-what-to-do-when-a-senior-goes-missing/

Australian Federal Police. “Elderly Missing Persons.” (accessed July 5, 2017) https://www.missingpersons.gov.au/how-can-i-help/prevention/elderly-missing-persons

AARP. “When Elders Go Missing.” (accessed July 5, 2017) http://www.aarp.org/relationships/caregiving/info-02-2011/when_elders_go_missing.html

Project Far From Home. “Part III b: Special Challenges: Alzheimer’s Disease.” (accessed July 5, 2017) http://www.k9team.org/files/articles/Project%20Far%20From%20Home%20-%20Missing%20at%20Risk.pdf

Alzheimer’s Association. “Three out of Five People with Alzheimer’s Disease Will Wander.” (accessed July 5, 2017) http://www.alz.org/norcal/in_my_community_18411.asp

NBCNEWS.com. “Silver Alerts help track wandering seniors.” (accessed July 5, 2017) http://www.nbcnews.com/id/26293194/ns/health-aging/t/silver-alerts-help-track-wandering-seniors/#.WV2GFdPyv-Y

Family Strife over Elder Care? Consider an Elder Mediator

One or both parents requiring care can create serious stresses and conflicts within families. Sometimes disagreements and misunderstandings over elder care or inheritance issues can lead families to break apart, affecting descendants for generations. To avoid this, elder mediation is available to resolve family disputes that otherwise may go unaddressed or lead to costly and traumatic litigation. A successful resolution can preserve family ties to the benefit of the entire family tree.

Situations where elder mediation can be the best route to keeping families together can include the following:

• Mom or Dad is beginning to need help and family members (as well as Mom or Dad) can't decide on the best living arrangement: stay at home with help, move in with one of the children, move to assisted living, or move to an apartment.

One child decides to leave work to move in and take care of Mom. Should she be paid for doing so and, if so, how much?

Dad moves in with daughter and son-in-law, who need to build an addition onto their house to accommodate him. Should Dad pay for this? If he doesn't live there long, should other siblings be compensated?

Daughter is taking care of Mom and Dad, driving them to appointments, visiting them daily, helping them pay their bills. She resents the fact that her brother in California isn't helping out and she doesn't share any information with him. The brother feels both guilt and relief that his sister is taking care of their parents, but he's also questioning some of the decisions she makes and isn't convinced that his sister isn't siphoning off some of their parents' funds.

Through all of such situations, Mom or Dad is telling each child more or less what he or she wants to hear in order to avoid arguments, but creating trouble between the children.

Mom in her estate plan wants to give her divorced daughter more than her highly successful son, but is afraid that the son will feel hurt and unloved.

The family has a vacation home that the parents would like to have stay in the family, but some of their children use it more than others. How can those who don't use the house be compensated? Should there be a buy-out mechanism? How will operating expenses be funded?

After the parents pass away, family members are fighting over personal belongings of little monetary value but of great sentimental importance. 

After Mom dies, Dad starts dating a younger woman and children fear that their inheritance will go to this new interloper along with the loss of their connection to their dad.

Some families can work out these issues on their own, but many cannot, and the disagreements or hurts either fester or break out into open conflict and, occasionally, litigation. Resolution through mediation can bring much better results.

The mediator doesn't make any decisions and doesn't take sides. Instead, the mediator listens to the issues, keeps the family focused on the goals, encourages consideration of all the options, and helps clear up misunderstandings and address hurt feelings. Through this process, the family can come up with answers to problems or ways of solving conflicts. The idea is not to have a winner or loser, but to have a solution everyone is happy with. At the end of the mediation, a settlement agreement may be drawn up to memorialize the parties' understanding. Because it is not a legal proceeding, the agreement is not binding, but the idea is to create an agreement that everyone will be happy to follow.

Mediators report that people often get stuck with their positions -- that Mom should move to assisted living, that the vacation house should be sold, that they should get the family silver because their sister already got the china. The mediators may try to get people to move away from these fixed positions by asking them to start by stating their interests. Are they concerned about Mom's safety? About saving money? About everyone getting exactly the same inheritance from Mom and Dad? About their own financial security?

When family members state their interests they often find that there's more common ground than appeared at first. Also, by giving every family member the opportunity to express themselves without as much fear of the reaction, they can also hear one another better.

The mediation process is voluntary and is often undercut by the unwillingness of one or more family members to participate. It takes time, costs money and there's no guarantee of success. But skilled mediators can often bring families back together who otherwise would break apart forever. This can be well worth the time and expense and may be much cheaper and more pleasant than the alternative.

To learn more, visit the following websites:

Mediate.com

Elder Decisions

The Association for Conflict Resolution