When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

When Is It Time to Place a Loved One with Dementia in a Long-Term Care Community?

As the pool of seniors in American becomes increasingly greater with each passing year, a frequent question more and more families are faced with is: “How do I know when it’s time to place my loved one with dementia in a long-term care community?”

Most long-term care experts will agree that every scenario can be unique and different. The general rule of thumb however is that there is really no downside to placing a loved one in community too soon. However, there are many drawbacks in waiting too long.

If your loved one requires a higher level of care, and for whatever reason(s) you decide to wait, the number of things than can potentially go wrong are endless.

Medication Management
In a facility like a memory care unit, all medications are carefully regulated. They are administered on a strict schedule, the nursing and care staff look for any indications that a resident’s regimen should be changed, and they can usually implement these changes quickly once the doctor has approved them.

When your loved one is living at home, all of the medication oversight falls to you. While many family caregivers learn a great deal while caring for their loved ones with dementia, there are certain signs and issues that only medical professionals can pick up on and address. Even if you do notice a problem, getting them to the doctor for an evaluation to change their meds can be a struggle.

Mobility Issues
Toward the end stages of dementia and Alzheimer’s disease, patients have extremely limited mobility. This is a serious hazard for both the patient and their caregiver. For example, a petite 70-year old woman could easily get hurt trying to get her 180-pound husband to the bathroom two or three times each night. Continuing to care for him at home puts them both in danger of falling.

Bathing, toileting, dressing, and other activities of daily living all come with risks, but a facility is far better equipped to safely handle any of these concerns. They have the proper equipment, training, and manpower to assist residents and prevent accidents.

Wandering
A loved one can easily get out of the house without their caregiver realizing, and this can be a life-threatening situation. Wandering can (and does) happen in facilities, but the residents are limited to spaces within the building and, in some cases, a secure area outside. This is why supervised memory care is so valuable for dementia patients and their family members. The residents are able to move about, but the premises are heavily monitored and often feature special security measures to prevent them from wandering away from the facility and getting lost or injured. The response time when someone does wander is greatly increased as well, due to the number of employees available to look for them.

Caregiver Stress
It doesn’t matter if you are in your thirties or in your seventies, the stress that dementia puts on a caregiver is the same. If you are in your thirties, chances are you are in reasonably good health, but older caregivers are more likely to have medical conditions of their own to contend with. Stress can quickly manifest itself in people of any age, and is known to exacerbate even minor ailments. Be honest with yourself about your emotional and physical limits while caregiving. Sometimes placement in a facility is best for both the caregiver and the loved one’s overall health and well-being.

Long-Distance Caregiving
Caregiving from afar rarely works, especially for loved ones with progressive illnesses like dementia. How could it? Some local family members can provide intermittent support, but they still struggle to stay on top of the level of care and assistance that their loved one requires. Adequate supervision and care can’t be provided from afar. The patient’s needs will continue to increase, and it will only put more strain on the caregiver and leave the person with dementia more vulnerable.

In a long-term care facility, yes, there are more residents, but there are also more caregivers. Unlike family member who lives across town or across the country, nurses and aides are on duty around the clock to ensure residents are safe and their needs are met.

Rely on a Plan, Not a Promise
The most important reason to have a plan way before it is time to even think about placement is because you probably make a promise years ago that you would handle a loved one’s care yourself. It is common for people to promise to take care of their parents, spouse, siblings, whomever and pledge to never place a loved one in a nursing home for any reason.

There is the fact however that as a patient, a person deserves and should demand to be taken care of to the best of one’s ability. A dementia patient’s daily care should not be substandard simply because of a promise their family member made some 20 or 30 years ago. We all have made promises we haven’t kept for one reason or another. This thing about, “I promised my mom I would never put her in a facility,” is noble, but that’s about it.

Sometimes it can simply be a matter of pride for caregivers. A caregiver doesn’t want their family to know that he/she is struggling with Dad, so they do the best they can, not even realizing that the care they are trying to provide is substandard. Every person deserves to be taken care of. A loved one may not be able to communicate or have any idea what is going on around them, but they deserve to have their dignity intact.

Placing your loved one in a long-term care community doesn’t have to be as dramatic as it is often portrayed to be. Communities that offer Memory Care are nothing like the nursing home setting of 30 years ago. It’s highly likely that neither the potential resident nor the caregiver has ever been in a specialized facility that cares for individuals with dementia, because most people don’t have a plan in place for that scenario.

There is research involved, a medical assessment of your loved one must be conducted, and there needs to be a financial plan in place to cover the costs of professional care. When you take your time to prepare, there is less drama and fewer surprises.

Do yourself and your loved one a favor and be prepared. Placing a loved one is one of the most loving things you will ever do for them. You are doing something your heart tells you not to, but you are doing something that your mind knows is the right thing to do. At the end of the day, this is exactly what you said you would do all those years ago….take care of them. When you can no longer manage, you seek out placement. This is, in fact, taking care of them.

My Parents Need Assisted Living. Where Do I Start?

My Parents Need Assisted Living. Where Do I Start?

It can be difficult to realize that dad or mom need more care in a setting like assisted living. Just as your parents kept us safe and secure when we needed it, there comes a time when we’re called upon to return this same caring concern with our parents.

Steps to Take When Your Parents Need Assisted Living

Some of us will provide care to our parents or senior loved ones in our own home for a period of time, but this scenario is not always possible for all families, or…always desired by the children or parents themselves. Many families will in turn, find themselves searching for an assisted living community. These communities provide an intermediate level of residential care for seniors who aren’t safe living by themselves.

Ideally, your parents can be full participants in the search, but if your loved one is impaired by Alzheimer’s disease or dementia, you may to proactively take more control of the decision making.

If you see that your parent(s) need assisted living, here are some steps that can help you find them the right care:

1. Determine what you can afford.
Like it or not, money is going to be a factor in many families’ searches. Look at what your family can afford on a monthly basis. You may be need to look into creative ways to pay for care, like social security, veterans benefits, or long-term care insurance if your parents have that available to them. Some families may have to consider difficult options such as pooling resources from the adult children, selling a family home, or even cashing in a life insurance policy.

2. Research assisted living communities in the area you are planning to have your parents live.
Make a list of needs and preferences and research which communities can meet those criteria while being in your price range. For those families who ultimately cannot afford private-pay senior care and will require state assistance in the form of Medicaid, an appropriate resource is your county’s Aging & Disability Resource Center (ADRC).

3. Visit a number of assisted living communities.
No amount of time viewing brochures, floor plans, photos, or reviews can substitute for an in-person visit to an assisted living community. Schedule visits for you and your parent at a minimum of three communities on your short list. If you and your parent have the time and stamina, it may be helpful to visit more communities as you narrow the search. A good time to tour is during a meal, such as lunch, so potential residents can try the food and get a good sense of the community’s culture; as many residents will be out and about during a mealtime. Based on these initial tours, narrow down your search to two or three favorites. Perform follow-up tours…perhaps even unannounced…to get a good sense for the community you and your parent are considering.

4. Include your parent or senior loved one.
The more involved your parents are in the search, the better. Of course, you can do much of the legwork for them, but have discussions with your parents about their desires and preferences and, ideally, present them with a range of options.

5. Prepare to move.
If you’ve come this far in the process, there’s no sense in delaying the move. It’s risky to procrastinate when a parent needs care, as the delay can lead to avoidable accidents and medical problems.

6. Work together towards a decision.
Whether your parent is choosing the community themselves or you need to make that decision for parents impaired by Alzheimer’s or dementia, try to make sure that everyone in your family feels good about the choice. When possible, have conversations with your parents discussing the pros and cons of each option and try to find consensus about the right option.

Solutions for Families Who Disagree About Senior Care for Their Parents

Solutions for Families Who Disagree About Senior Care for Their Parents

Caring for aging loved one can be one of the most stressful family milestones. The sheer difficulty of the task, its high cost, as well as underlying family issues can collide to create a perfect storm of discontent.

If families can put aside their differences and work together as a team for the best interest of their elderly loved one, they are often able to overcome this challenge and assure that their parent’s last years aren’t marred by bickering and strife.

Reasons Families Fight about Senior Care and Possible Solutions to Avoid Conflict

1. Siblings View Parent’s Need Differently
Adult siblings don’t always see care needs the same way. One child may have the impression that mom is doing fine at home while another feels that care must be put in place immediately.

Possible Solution: When siblings disagree about how much care a parent needs, or about whether the parent needs care at all, the conflict can often be resolved by seeking expert guidance. Arrange for a visiting nurse with a background in elder care assessments to see your older loved one at home and gauge the level of safety. Also seek information and guidance from the senior’s primary physician so that the assessment process is as thorough as possible. Clarification from healthcare professionals can help answer this question definitively instead of allowing it to become a point of contention that prevents progress from being made.

2. Parents Resist Care
Sometimes the whole family is on board and agrees that mom or dad needs care, but the parent resists any change tooth and nail. It’s understandable; people value their independence highly, and are loathe to give up any of it.

Possible Solution: When you’re trying to persuade a parent to accept a move to a senior community, make it clear that you’re not trying to “put them away.” Help your parent understand your concerns and that they come from love. Also educate your parent about the senior care options that are available in your area. Your parent may imagine moving to some dreadful institutional situation while you have something much different in mind. Today’s assisted living communities are attractive and comfortable may contrast sharply with what your parent is imagining. If your parent has advanced Alzheimer’s or dementia, you may be able to initiate proceedings if you have an activated Power of Attorney (POA) or you can go the route of obtaining guardianship (pretty much as a last resort), but you can’t force an elderly parent of sound mind to receive care.

3. Family Members Regress to Earlier Roles or Past Issues Resurface
When the immediate family comes together to care for mom or dad, they often can revert to dysfunctional and unhealthy roles of the past. Sibling rivalry that has been dormant during adulthood may suddenly rear its head again during the stressful process of caring for an aging parent.

Possible Solution: It’s not realistic to get along splendidly with everyone in your family, or for your parents needs to suddenly unite a family that was formerly divided. But recognize that you won’t always see the best behavior from your loved ones or agree with them on every issue. Encourage them to be caring and dignified during this process by setting a good example yourself. Be the “big person in the room” and avoid being sucked into feuds or bickering that feel as if they are a flashback to a disastrous family road trip of our childhood. Practice active listening, as family members who feel like their voice isn’t being heard are most likely to become frustrated.

4. One Child Does All the Heavy Lifting
Often the child who lives closest to mom or dad will be the one that assumes the role of the main caregiver. When other family members don’t offer to help, the “lucky” child who is giving all the care can come to resent the siblings who have gotten off without having to help.

Possible Solution: Caregivers who have found themselves shouldering an inordinate portion of the burden from caregiving shouldn’t be afraid to ask other family members for help. Sometimes it is necessary to spell out your specific needs to your siblings rather than presuming that the needs are already understood. Outline to your siblings the challenges that you’re having, and any areas that they may be able to help with. While they may not be close enough to physically offer a hand, they may be able to contribute in other areas, such as paying for caregiving relate bills. They may also be able to host your parent in their home for short periods so that you can have a break.

5. One Child in Control Excludes Others from Decision Making
A scenario almost opposite of the previous example occurs when one child takes over the caregiving role and leaves their siblings or other family members in the dark, perhaps even limiting access to their parent.

Possible Solution: It hurts to feel left out, but if your parent’s care needs are being met and they seem safe and happy, it might not be necessary to intervene further right now. If your relationship with the caregiving loved one is strained and you’re less involved then you’d like to be, strive to maintain an ongoing relationship with your parent nonetheless. If your parent doesn’t have a memory disorder like Alzheimer’s, you should be able to maintain a relationship by contacting your parent on the phone. If your sibling is acting as a gatekeeper and prevents you from reaching your parents this way, write emails or letters to show that you care, learn about the situation, and stay in touch.

6. How to Pay for Senior Care
For many families, the most challenging part of arranging care is the question of how to pay for it, particularly when our parents don’t have the funds to pay themselves. This scenario is increasingly common as many seniors’ retirement accounts still haven’t recovered from the 2008 global economic meltdown and subsequent recession. Unless funding for care is found through government assistance like Medicaid or veteran’s aid, the adult children will have to look to their own pockets to pay for care…or they may look to one another. Should a sibling with a big income contribute more than a sibling who earns less? Should a family member who has been providing unpaid personal care be exempted from having to contribute? These questions, and others like them, have frequently kindled fiery conflicts.

Possible Solution: Open communication is essential to preventing conflict. We shouldn’t presume that siblings will necessarily be able to contribute as much as we hope. If the cost of your parent’s care will require the grown children or other family members to help pay for the care, call a family meeting with all the people involved right away. Realistically establish the cost of care, and determine how much money needs to be raised between all the involved parties. Start by determining how much each person believes they can contribute, and if funds are still short, dig deeper as a group, talking about what each person might be able to sacrifice to make arrangements work. When these decisions are made in the open, with everyone at the table, future conflict is less likely. It’s only natural that the process should be as fair as possible, and that a sibling with a low income should not be expected to contribute as much as a sibling with a high income, but not all families agree on what’s fair and what isn’t. In these cases, the voice of a neutral but knowledgeable outsider can be beneficial. Other professionals, such as elder care mediators, can also help iron out areas of disagreement and help families build consensus.

7. Balancing Caregiving with Raising a Family
According to data from the National Center on Caregiving, 60% to 70% of family caregivers are women. Very often, the same woman is raising children of her own (a “sandwich generation” caregiver) and balancing the demands of a career to boot. It’s understandable that someone juggling these demanding roles, each of which could be considered a “full-time job,” might get burned out and irritable.

Possible Solution: Understand that your caregiving loved ones have limits and are not superheroes. Do what you can to ease the burden. Offer to help care for mom or dad, or your loved ones children, so she can have some time for herself. On the other hand, if you are the “sandwiched” family member and feel like you’re hanging on by a thread, don’t be afraid to ask for help. Consider arranging a family meeting to reorganize care for your older loved one in such a way that burden is shared more evenly.

8. Caring for Both Parents at Once
While it’s great that your parents have been able to grow old together, caring for two parents simultaneously is doubly challenging. When both parents need advanced care, the physical and financial strain is immense. But it’s also challenging when the level of care needed is imbalanced, or the two parents need different kinds of care. For example, one parent might need Alzheimer’s care while another needs skilled nursing. The heart wrenching prospect of having to separate your parents can cause tempers to flare, and the physical, financial, and logistic complexities of arranging care for two loved ones at once can raise stress levels to an all-time high.

Possible Solution: Try to talk with representatives from agencies like your local Aging & Disability Resource Center (ADRC) or another local expert to learn about care options for your parents that you might not even be aware of. Many communities offer multiple levels of care, or even different kinds of care, which allows married couples to remain together when they wouldn’t ordinarily have been able to do so. Hold family meetings to ensure that everyone understands each other’s concerns, and work to define a mutually agreed upon strategy for caregiving.

9. End of Life Care
Loved ones often battle fiercely about end of life care. One child may want to arrange hospice care for a terminally ill parent, while another may advocate that every day lived is a victory. In both cases, family members want what is best for their older loved one, but disagree about what that means. This type of conflict can be avoided when seniors, well before a medical crisis, write a living will (also known as a healthcare directive) that specifies end of life wishes while also appointing a health care proxy to help implement the specified plans.

Possible Solution: Make sure that your parent has drafted a living will (or healthcare directive) and has designated a healthcare proxy. These documents are easily available online or by checking with your parents’ primary healthcare provider.

10. Estates and Inheritances
It’s incredibly sad to see families fight over an inheritance, but it happens all too often. Whether the dispute is over a treasured family heirloom or a large sum of cash, it can get ugly fast. These unfortunate battles frequently occur when a will hasn’t been written or has become out of date, but they can even occur in cases when reasonable and appropriate estate planning measures have been taken.

Possible Solution: Disputes about inheritances can be ideal cases for family mediators. A family mediator’s job is to analyze these situations fairly and objectively, while helping families find areas of common ground. While a perfect compromise may not be found through meditation, it’s almost always preferable to suing a close family member over an inheritance.

Are You Putting Off a Move to Assisted Living?

Are You Putting Off a Move to Assisted Living?

A move to an assisted living or senior living community may be one of the best decisions a family can make for a parent or senior loved one’s happiness, health and safety, particularly when they need more care than we can provide or they’re suffering from social isolation.

Lots of families delay this all-important decision, however, feeling helpless as their parent’s needs escalate and their own caregiving stress increases.

Five Reasons That Families Put Off a Move to Assisted Living

Making a decision about assisted living is not easy or straightforward and there are a variety of reasons why families and seniors may try to avoid discussing this difficult topic. The following are five of the most common reasons families might delay a move to senior living, along with some possible solutions for tackling each obstacle:

1. “I live too far away to make a decision.”
Geographic distance — living at a distance or in another state from their loved one — is often cited by family members as a reason for delaying a move of their loved one to an assisted living community. A recent study by AARP and the National Alliance for Caregiving showed that 15% of family caregivers live one or more hours away from their care recipient. Living at a distance poses extra challenges to those searching for assisted living, adding stress and making logistics and timing difficult.

Possible Solution: If you are looking at the possibility of managing your loved one’s care at a distance, you are not alone. To make the process easier, schedule family meetings with other involved loved ones to discuss decisions ahead of time. Make sure to organize all the important documents and paperwork you might need, so everything is in place in case your loved one’s health situation changes unexpectedly. Seek help from online and offline resources and referral services in order to determine what will fit your loved one’s needs and your family’s budget.

2. “I need to talk with my loved ones about assisted living care.”
Many folks will say that they have delayed their loved one’s move to assisted living because they haven’t had the opportunity to talk with family and friends about it first. It’s human nature to put off the decision because it is difficult to coordinate with other family members, or because we want to talk with experienced or trusted friends before figuring out what to do. Of course, it is painful to think about an aging loved one’s declining mental or physical health, which makes it easy to delay having those tough conversations. But doing nothing about it may put our loved one’s health at greater risk. It’s important to discuss issues such as health, logistics, and scheduling before they become real concerns.

Possible Solutions: First, be honest with yourself about your own feelings and why the delay is occurring. Think realistically about what will happen if you do nothing about their situation versus what will happen if they move to assisted living. Don’t be afraid to seek help from a counselor, friend, or support group and…don’t forget to involve your loved ones when it’s time to make a decision. Just don’t put it off forever. If it’s pre-existing family conflicts getting in the way, remember that the focus should be on the welfare of your loved one and set a good example by trying your best to rise above sibling rivalries and making sure everyone’s viewpoints are heard.

3. “I want to do more research.”
In the aforementioned study, the greatest number (27%) said that their top reason for putting off the move to assisted living was to allow them to do more research — from calling communities to driving by the property to looking at websites. Families often worry about the ratings of the community and about what the community offers residents.

Possible Solutions: Researching assisted living care can seem daunting, but there are numerous resources available for families to utilize in evaluating specific communities as well as different types of care. In the Eau Claire area, a very helpful resource is the Eau Claire County Aging & Disability Resource Center (ADRC). Their counselors can provide you with excellent advice and insight into the various assisted living communities available nearby. The key is taking that first step toward seeking out help.

4. “I’m concerned about assisted living costs.”
With the media monthly cost of assisted living rising, (typically $4,000 to $5,000 per month on average in the Eau Claire area) it’s no surprise that sticker shock is one of the reasons families and seniors delay the move to assisted living. Again, in the same survey, 13% of respondents cited budget uncertainties or high expenses as a delaying factor.

Possible Solution: An important fact to remember is to check what is included in the monthly cost of assisted living. In many cases, amenities such as housekeeping, meals, utilities, etc. are included. The key is understanding what the costs mean and what value you are getting for your money.

5. “My mom/dad/parents are not ready to leave their home.”
There are a number of specific reasons why a loved one might be reluctant or even afraid to move into senior living. They may worry about losing their independence, they may fear that others won’t care for them properly, or they may worry about being bored. They may not feel they need to be in a “nursing home,” or they may be attached to their current home or pets and be understandably reluctant to consider the idea of parting with treasured possessions and memories in order to move into a smaller space.

Possible Solution: Get informed about the most common fears associated with assisted living and other retirement housing options and learn what you can do to openly acknowledge and discuss these fears rather than letting them derail the conversation. Once your loved one can articulate his or her worries and feel like they are being heard, you can take steps to alleviate their fears. Then you can work together to discuss senior living options that value residents’ dignity, independence and privacy. Talking to a loved one about downsizing their possessions can be difficult, but once the conversation is open, you can encourage them to enlist trusted family and friends or even a professional move manager.

While these aren’t the only reasons families delay a move to assisted living, they are definitely some of the most common. Being prepared and having realistic expectations will help you avoid potential roadblocks.

Tracking Possible Alzheimer’s Behaviors in Your Parents

Tracking Possible Alzheimer’s Behaviors in Your Parents

An Aging Parent’s Behavior

Are you concerned about an aging parent’s cognitive skills? If you have concerns about an aging parent’s behavior or memory, you’ve probably wondered if they have Alzheimer’s or another dementia. What should you do about your worries? Tell the doctor.

If you’d like to share your concerns with your parent’s doctor but are worried about upsetting your parent, send the doctor your concerns in writing. No HIPAA authorization is needed for you to share your concerns with a parent’s health professional.

However, if you, your parent and your parent’s doctor truly want to get to the bottom of things, you take a simple approach that is incredibly effective: start taking notes on the behaviors known to correspond with Alzheimer’s.

By doing so, you’ll be gathering the kind of detailed information that doctors need in order to confirm cognitive issues and likely detect the disease.

Eight Alzheimer’s Behaviors to Track

• There are eight Alzheimer’s behaviors to track and for each of the behaviors, it’s important to take down the following:
• What kinds of problems you see your parent having now
• When you — or another person — first noticed problems, and what you observed
• Whether there’s been a change or decline compared to the way your parent used to be
• Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath, or physical disabilities

Note: If you don’t notice a problem in any of the following areas, be specific in documenting this, e.g. “no problem detected.” That way, you and your family will know you didn’t forget to consider that behavior.

1. Daily Struggles with Memory or Thinking
It’s normal for older adults to have a lapse here and there. But if your parent seems to experience a memory or thinking problem every day, make a note of this. It’s a good idea to add specific examples describing what you or another person observed.

2. Difficulty Learning to Use Something New
Any difficulty learning to use a new appliance or new gadget, such as a smartphone? Make note of what your parent has difficulty adapting to and how he or she tried to manage.

3. Difficulty Managing Finances
Have you noticed any problems managing bills, expenses, or taxes? You might have to ask your parents about this if you aren’t usually involved in their finances.

4. Forgetting the Month or Year
Any difficulty keeping track of the current year or month? If it happens more than once, make a note of that especially.

5. Poor Judgment
Have you noticed any behaviors or situations that seem to indicate bad decisions? Any excessive or unusual spending? Or perhaps a poor understanding of safety concerns that everyone else is worried about? Write down anything you or another person close to your parents has observed.

6. Problems With Appointments and Commitments
Has your parent missed any appointments or forgotten about a get-together that you’d planned? Everyone forgets something occasionally, but if this happened repeatedly, be sure to document when it started and how bad it’s gotten.

7. Reduced Interest in Leisure Activities
Have you noticed that your parent no longer seems interested or involved in any hobbies? For example, did your mother read voraciously but now seems disinterested in even picking up a book? Any change in hobbies or leisure activities should be noted, especially if such a change doesn’t seem to be related to a problem with physical health.

8. Repeating Oneself
Any repeating of stories? Any asking the same questions repeatedly? Has your parent been declaring the same thing, e.g. “I really love those roses you gave me!” over and over again? If so, write it down.

How to Detect Alzheimer’s Disease

The eight behaviors previously mentioned correspond to the brain’s ability to learn or manage memory and judgment. To diagnose Alzheimer’s or another dementia, your parent’s doctors must document that your parent has been having persistent difficulties in two or more areas related to brain function. (This is necessary but not sufficient for diagnosis as doctors must also rule out other causes for thinking problems).

Now, doctors can assess the different aspects of brain function through certain office-based thinking tests. However, research has found that asking family members about the behaviors above can be just as effective when it comes to spotting probable dementia, including Alzheimer’s disease.

Getting this type of observational information from family members helps doctors determine whether the behavior is a persisting, and maybe even worsening, problem. This matters because a single office-based test only provides a snapshot of how your parent’s brain is doing on that particular day.

As a rule, most doctors appreciate getting these kinds of behavioral observations from families because it provides very practical information related to people’s daily lives. By knowing more about what kinds of problems an older person has been experiencing, doctors can make useful recommendations right away to help families with family conflicts, independence, and safety.

Ways to Help Your Parents Get the Right Care

Doctors who are knowledgeable about dementia will ask a family about problems related to the eight behaviors above. Unfortunately, many primary care doctors aren’t experienced in evaluating dementia. It’s not unusual for a physician to wave off concerns or tell the family that this is just what happens when people age. This can often easily happen partly because families are often a bit vague when they voice concerns. This means the doctor has to do more work in investigating the concern and in documenting specific problems that can help diagnose Alzheimer’s. Some doctors will do this work, but since office visits are often rushed, many of them won’t get around to it.

Unless that is, you bring detailed information to help the doctors take further action. The more specifics you can share regarding what you’ve observed, the more likely you’ll get the help your parent and your family need. Plus, whether or not Alzheimer’s caused these behaviors, they often cause anxiety and frustration within families. So it’s important to bring them up to a doctor so that you can get help understanding the cause and learn what to do next.

Don’t go on for too long with the worrying and the wondering. Take notes so that you can then take better action.

Four Things Siblings Feud Over Regarding Their Parent’s Estate

Four Things Siblings Feud Over Regarding Their Parent’s Estate

Many people think sibling feuds only occur when we are young. In some cases, this is true, but for some brother and sisters this feud can continue into adulthood, tearing families apart.

Caring for an elderly parent or selling their estate once they have passed can sometime create a tenuous situation or add to an already existing one. When parents divide their assets to their children, they don’t expect such fights to occur, but it can be the case.

The following is a list of common concerns along with solutions to prevent a major feud from occurring.

1. No Healthcare Directive and Power of Attorney
When a parent gets sick it can be stressful, especially if they need to be hospitalized for an extended period of time. This can become more challenging if their situation becomes critical and they are unable to voice their healthcare or financial wishes. If a parent does not have a Healthcare Directive or Power of Attorney, their loved ones are forced to make the decisions for themselves. This can cause conflict between siblings if they are unable to agree on a decision. In some circumstances, siblings have even taken each other to court to fight for their side. This can cause a rift in their relationship, costly court fees, and lost time that instead could be better spent in caring for their parent.

To avoid this conflict, parents should create Healthcare Directive and Power of Attorney:

A Healthcare Directive specifies your wishes for medical treatments, and allows you to appoint someone to carry out your wishes if there is ever a time when you are no longer able to communicate or provide consent.

A Power of Attorney allows you to appoint someone to look after your financial affairs such as your property, while you are in the hospital.

2. No Last Will or Testament
If both parents pass away without a Last Will and Testament, a family can be faced with chaos. In some jurisdictions it will be up to the children to decide who gets family heirlooms, household objects, and other family possessions. This can cause fights between siblings if they want the same thing or can’t agree on how to equally divide the items. With their parents not around to decide who gets what, siblings may become resentful to each other, which can lead to their relationship dissolving.

Parents should create a Last Will and Testament and specify who gets what. They can identify items and give them as gifts to their children. Creating a Last Will and Testament not only ensures your loved ones are looked after, but it decreases the chance of siblings fighting over material possessions.

3. Lack of Communication
In some cases, having a Last Will and Testament is not enough to stop sibling feuds from occurring. For instance, parents may decide to give one child a precious family heirloom, or more money because they were their sole caregiver. This can cause the other sibling or siblings to feel jealous and neglected. A lot of times, parents don’t discuss their will with their children as it can be uncomfortable talking about money or when they won’t be around. However, this lack of communication can cause more problems between siblings because it is too late to hear their parents’ reasoning.

Parents should communicate with their children about their will so they are aware of the contents and are able to have an open discussion. When deciding about heirlooms or possessions many people use the “sticker method.” The sticker method allows siblings to take turns in deciding what they want by placing their sticker on an item.

4. Wrong Executor
When creating a Last Will and Testament, parents will have to appoint an executor. An executor will distribute their assets of the estate in accordance with the direction of the will.

Parents sometimes appoint only one child to be their executor. Since the executor has the power to make decisions it can create some tension between siblings. Arguments can arise because they may feel jealous that their sibling is the executor or that their sibling is abusing their power and not carrying out their responsibilities.

Parents can add a clause in their will that decisions cannot be made unless there is a majority or a unanimous vote. This will allow the family member who is the executor to not abuse their power for their personal interest.

Parents can also select a third party as their executor. This can help alleviate tension between siblings as the executor is impartial and has no personal interest to the estate.

Getting Started

Dealing with an ill parent or their estate once they pass can be difficult, and having support through your siblings is important. However, sibling feuds can get in the way and cause conflicts during this time. Having your parents’ estate planning documents in order not only ensures their health care, finance and estate decisions are being taken care of, but that siblings are able to be there for each other instead of fighting.

Getting started is easier than you may think as there are many resources available. Check out the website: www.LawDepot.com, a leading publisher of do-it-yourself legal documents, which offers planning documents and a free, one-week trial which is available to help get you started.

Why More & More Seniors Are Preferring Senior Living Communities

Why More & More Seniors Are Preferring Senior Living Communities

Today’s senior communities can range from homelike to the luxury of a high-end hotel. One thing that they don’t feel like is institutional. Most seniors who have moved to an independent or assisted living community report that they definitely prefer life at their new home vs. living alone in their own home.

Here are some common reasons why:

1. An End to Stressful Driving
Driving can become more stressful as we age and our driving abilities may not be what they once were either. For these reasons, many residents prefer to take advantage of the access to transportation offered by assisted living communities. There’s no need to rely on a car any longer, although parking is typically available for residents who still drive.

2. Better Food
There are many seniors who are used to living alone and may not currently be eating right. At senior living communities, residents don’t have to worry about grocery shopping or meal preparation. Instead, they can enjoy a fine dining experience every day of the week. The food tastes good, alternative meals are almost always offered and special diets can ordinarily be accommodated. It’s common for new residents, who had been eating poorly before they moved, to experience improvements in their health and well-being just from having access to three square meals per day.

3. Feeling Like Myself Again
Living alone, we may not be able to participate in activities and games we enjoyed, that were fun and helped keep us sharp. But senior communities offer a wealth of opportunities to keep us engaged. This can include activities like favorite card games, chess, cribbage, or even Nintendo Wii and corn hole bag toss. Engaging reading and discussion groups, classes, and lectures on a myriad of topics are also available.

4. Feeling Safe
Residents can rest easy knowing that they are secured from ne’er-do-wells. Furthermore, residents enjoy the peace of mind that comes from the emergency response systems that are in each apartment, or in many cases on the resident’s person as safety pendant. This alleviates fears about falling and becoming trapped for hours or even days, a scenario that’s all too common for senior’s residing alone. Certainly, there are seniors who live alone and are just fine. While senior communities aren’t for everyone, there is without a doubt vast numbers of seniors living alone in unsafe or unhealthy situations who would benefit immensely from life in a senior community.

5. Improved Family Relationships
Older folks frequently become dependent on their grown children, or other close family members, for help of all kinds. Unnatural role reversals can strain relationships and foster unhealthy feelings of resentment, both by parents and their children. Younger family members are liberated from the role of full-time caregivers and are able to assure that time with their older loved one is high-quality and meaningful. Older residents are glad to return to the role of family matriarch or patriarch and often pleased that their grown children no longer have to “parent the parent.”

6. New Friends
Older adults who live alone often become isolated, which is unhealthy at any age. At senior communities, individuals can make new friends and share meals with each other. On the other hand, persons who are more introverted appreciate that their privacy is respected, but are still glad to have folks around.

7. No Stress Home Maintenance or Yard Work
Keeping up a home is hard, especially for those persons who have developed physical ailments. Mowing the lawn, shoveling/blowing snow, pulling weeds, vacuuming — these become things of the past. If you are a green thumb, many communities have gardens or raised planters that allows you to “adopt” a garden.

8. Vanquishing Boredom
Residents need never be bored at a senior living community. There’s something for everyone. All kinds of activities and entertainment are offered, both on-site and in the local community. Entertainment can range from visiting musicians and performers, to day trips that might include local landmarks, forays into nature, or just an outing to a local park.

Redirecting a Loved One With Dementia

Redirecting a Loved One With Dementia

Redirecting a Loved One With Dementia

Alzheimer’s disease and dementia, which affect memory and other cognitive abilities, can create anger, anxiety, confusion and fear for a person living with the disease. It doesn’t help that explaining and reasoning with person dementia probably won’t ease their frustration.

An approach called “redirection” however, frequently helps. Redirection is a technique that is used to shift a distressed person’s attention away from the situation that is causing anger, anxiety, fear, or dangerous and unsafe behavior to a more pleasant emotion or situation.

How to Redirect a Parent or Senior Loved One

It’s happening again. Even though you’ve explained many times to mom, who has dementia, that she can’t call her sister Marie, who passed away five years ago, mom insists on calling her right now.

To make matters worse, she’s become agitated, even paranoid. “What have you done with Marie? Why won’t you let me call her?” mom asks. At this point, you are at a total loss as to what to do to calm her down.

When a person has dementia, he or she is unable to process information like they used to. That’s because dementia’s impairments aren’t restricted to memory loss. Those diseases also compromise the “executive functioning” capabilities of insight, judgment and reasoning. As a result, your loved one with dementia can be incapable of telling the difference between a hallucination and reality. Trying to explain why that person’s perceived reality isn’t true is pointless. Such an explanation can escalate already strong emotions.

Steps to Consider When Redirecting a Loved One With Dementia

It is possible to find ways to still stay connected to your loved one with dementia so they don’t feel that you’re trying to bully or push — which can easily backfire. Instead, try to understand that your loved one’s anxiety, fear, or other emotion probably stems from frustration or feeling out of control. For example, a person with dementia may ask the same question again and again because they have trouble processing the answer.

Fortunately, redirection can sometimes alleviate frustration for both the person with dementia and their family caregiver.

The following tips provide advice on how to redirect a loved one with Alzheimer’s or dementia:
 

  1. Assess the environment.
  2. Is the room too hot or cold, but your loved one can’t find the words to express that? Is the space calm and comforting or noisy? Sometimes, it’s the environment itself that needs redirection.

  3. Don’t try to explain or reason.
  4. If mom keeps pushing furniture against a door and insists that someone is trying to break in, explaining that no one is attempting to get in probably won’t ease her fear. Instead, try responding to the emotions behind the actions. You don’t have to say, “I believe this is happening,” but you can say, “I’m so sorry this is happening to you.” You might also say, “Mom, I really want you to feel safe. How can I help you feel safe?” In this scenario, you realize what is causing your loved one’s agitation and redirect her feelings from a place of insecurity to one of security because she feels like you finally believe her and are on her side.

  5. Go outside.
  6. Try to step outside for some fresh air and a change of environment if you can. Light and sunshine are healthy and help redirect the brain.

  7. Keep it simple.
  8. Try to keep conversations simple and direct. For example, if the person resists bathing, instead of saying, “I need you to come to the bathroom so you can take a bath and shave and I can wash your hair,” a simple “Dad, we’re going to the bathroom” is easier to comprehend. Asking for one thing at a time helps keep things simple.

  9. Use bridge phrases to put the focus back on the person.
  10. If Mom won’t eat and says she’s not hungry, you don’t have to push. Instead, try a ‘bridge phrase’ that moves the conversation to a different place. For example, you can tell Mom how much you always loved her fried chicken and ask her if she remembers how the house used to smell while it cooked or how she prepared the meal. Then a little later, maybe return with, “hey, how about we both have a bite of this sandwich?”

  11. Use touch to calm and focus.
  12. Not everyone with dementia feels comforted by touch. However, if the person is okay with it, touching that person’s arm or shoulder or gently hold their hand can be comforting and grounding. With redirection, keep in mind that one technique may work fine one time but not the next, so it’s a good idea to have several options on hand. The whole idea of redirection is that you want the person to feel cared about and listened to and make sure they’re in a safe situation.

     
    If you or your loved one are considering a memory care facility, learn more about Eau Claire memory care here. Our professional memory care team can answer your questions and help you navigate your situation.

Helping a Senior Loved One with Downsizing

Helping a Senior Loved One with Downsizing

The prospect of downsizing can be a difficult one for seniors facing the move to an assisted living facility. A lifetime of memories associated with possessions can be daunting to wade through for families and caregivers.

But, rest assured, there are ways to help ease the transition for your senior loved one.

Downsizing is an inevitable part of moving to a new residence: taking old clothes to Goodwill, throwing away that leaf blower that hasn’t worked in five years, and getting rid of all the things you’ve accumulated that your family no longer needs.

But, downsizing can be particularly wrenching for the elderly, who may find it overwhelming to think about letting go of the items they’ve gathered over a lifetime. If a senior loved one is faced with a move to assisted living where there may be less storage space, that clutter in the closet may turn into a stubborn roadblock — or even a justification to resist moving.

This can mean a tough conversation for family caregivers, who are usually the ones faced with confronting their parents about downsizing. Fortunately, there are strategies you can follow to make the process easier, even if a senior loved one has a more serious hoarding issue.

Does Your Senior Loved One Need to Downsize?

Getting rid of longtime possessions we’ve grown attached to isn’t easy for anyone, but for our elderly loved ones, it can feel like giving up cherished memories, especially if they are faced with leaving a long-term home on top of it all.

This isn’t just a matter of the occasional senior citizen not wanting to give up the mementos. In fact, it’s quite common. A recent study looked at survey data from 22,000 participants and found that about 30% of people over age 70 had done nothing to give away belongings over the past 12 months. Yet…more than half of the respondents in all age categories believed they had too many belongings. As an example, 56% of those aged 50 to 59 and 62% of those 70 to 79 reported having more things than they needed.

For these folks the problem isn’t denial, but rather, the extraordinary difficulty associated with giving up items that are so closely linked to their identities, their past, and their memories.

When Clutter Gets Out of Control

Sometimes it isn’t so easy to convince your loved one that they have too much stuff. If their collection of belongings is actually impairing their everyday functioning and threatening their health or that of others, they may be suffering from an elderly hoarding disorder.

It’s important to note that if you know of someone who is having trouble letting go of personal possessions and is distressed at the thought of discarding them, that alone may not constitute elderly hoarding behavior. However, if a person’s clutter is so extreme that their living space is unusable, unsanitary, or hazardous, or if they are exhibiting symptoms like self-neglect and social withdrawal, it may be time to consider whether they have Diogenes Syndrome (elderly hoarding disorder) and whether they should move into assisted living.

Tips for Talking to Your Parents about Downsizing

Whether you suspect your loved one has senior hoarding issues, or they simply have too much stuff for a small assisted living apartment, broaching the topic of downsizing can be a scary thought. You might be wondering, how can I ask mom and dad to give up so many memories they obviously cherish, and risk upsetting them?

Enlisting trusted friends and family to help your loved one clear their clutter can be an enormous help. Having others around to share memories with can make the process less painful, for one thing. It can also make it less overwhelming and time-consuming as seniors can easily be daunted by the size of the task, or feel physically incapable. Sometimes, though, the situation is so dire that professional help is warranted. Senior move managers can help the elderly downsize their possessions and are experts at helping with the transition into senior living.

The end result can be a hassle-free transition and a much lighter load.

Communicating With A Loved One Who Has Alzheimers

Communicating With A Loved One Who Has Alzheimers

How Do I Talk to My Loved One Who Has Alzheimer’s?

It’s indescribably painful to witness the deterioration of a loved one who suffers from Alzheimer’s disease or another type of dementia. As the disease progresses, we see minor forgetfulness morph into severe impairment, eventually causing communication to become a problem. In some situations, a memory care facility may be a needed option for individuals.

Knowing how to communicate and connect with our loved ones who suffer from forms of cognitive impairment is important as the disease progresses.

How to Communicate With Someone with Alzheimer’s or Dementia

According to the Alzheimer’s Association, one in 10 Americans have a family member with Alzheimer’s, and one in three know someone with the disease. Since people are living longer, more and more Americans are suffering from memory disorders — which means every family is likely to be affected at some point.

Learning techniques about how to act and what to say to someone with Alzheimer’s or dementia can help families emotionally connect with their loved ones. As with any brain disorder, there are special approaches involved with communication.

You can’t be judgmental or critical to aging loved ones who suffer from memory impairment or dementia, and asking detailed questions is probably not the best idea. When all else fails, ask open-ended questions and keep the conversation going smoothly. Help your loved one feel comfortable as the human connection is the most powerful.

Listed below are some strategies to help you and your aging loved ones maintain a positive relationship, despite Alzheimer’s or dementia.

Ways to Act Around Someone With Alzheimer’s or Dementia

If you want to meaningfully connect with your loved one who suffers from memory impairment, you have to set the mood.

Here are some tips:

1) Avoid distractions. Create a comfortable ambiance that doesn’t have a lot of stimuli so that your loved one can focus all their mental energy on the conversation.

2) Be a good listener. Not your head and interact with your loved one’s conversation. If you don’t understand something, politely ask open-ended questions.

3) Don’t criticize. Be compassionate and do not try to correct your loved one if they are inaccurate. Feel free to go along with their delusions and misstatements to see where the conversation takes you.

4) Use a calm voice and warm tone. Don’t be condescending and don’t use heightened emotion. Speak clearly using a calm manner.

5) Use names. Avoid pronouns and refer to people by their names. Be sure to greet your loved one with their name.

6) Use nonverbal cues. Keep eye contact and smile around your loved one. Maintaining an inviting demeanor will help your loved one stay at ease, and comfortable body language can help your loved one recognize that you are someone familiar, even if they don’t recognize or remember exactly who you are.

What to Say to Say to Someone With Alzheimer’s

People who suffer from memory impairment have trouble expressing emotions and thoughts, and also have trouble understanding others. Even if you think your loved one has become a shell of a person and is no longer there — they are. You just have to figure out a different way to reach them and know what to say to someone with Alzheimer’s or dementia.

The Alzheimer’s Association provides several “do’s” and “don’ts” for effective communications:

DO

  • Accept the blame when something’s wrong (even if it’s a fantasy)
  • Agree with them or distract them to a different subject or activity
  • Allow plenty of time for comprehension…then triple it
  • Avoid insistence — try again later
  • Be cheerful, patient, and reassuring
  • Eliminate “but” from your vocabulary, substitute “nevertheless”
  • Give short, one sentence explanations
  • Go with the flow
  • Have patience
  • Leave the room, if necessary, to avoid confrontations
  • Practice 100% forgiveness
  • Repeat instructions of sentences exactly the same way
  • Respond to the feelings rather than the words
  • Speak clearly and naturally
  • Talk about one thing at a time

DON’T

  • Don’t argue
  • Don’t confront
  • Don’t question about recent memory
  • Don’t try to reason
  • Don’t remind them that they forget
  • Don’t take it personally

It’s also important to recognize what you are up against. Memory disorders continue to get worse with time, so your loved one will not improve; and you have to accept that. You need to have patience and make the conversation as pleasant as possible.

Remember to Be Patient

There is currently no cure for Alzheimer’s or other forms of dementia. The human brain is very complex and your loved one will have both bad days and good days. Learning to be patient with these behavioral variances is key. Knowing how to act around someone with Alzheimer’s or how to help someone with Alzheimer’s will only go so far.

Be kind and remember your loved one for their good times. Above all else, be loving and respectful, as they need you now more than ever.

To learn more about how to communicate effectively with a loved one with dementia, consider contacting the Eau Claire Aging & Disability Resource Center (ADRC) or visit their website at: Eau Claire County Dementia Coalition. The ADRC has a wealth of information about coping with dementia. They also offer dementia-related support groups that you can attend. The Classic actually hosts one of the groups on the 2nd Wednesday of each month. Click here for information about memory care in Eau Claire.