Articles Posted in Memory Care

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About one-half of the clients who engage me for my services do so after they have already selected a community for a loved one. Then, when a problem arises, they call me to help fix the problem. Unfortunately, no one has a crystal ball and can anticipate some of the unusual circumstances that can arise. Most of the time, clients are so pre-occupied with fixing the senior living problem that exists now, they do not consider what can happen in the future. Clearly no one is to blame, as it is always what we do not anticipate that causes a problem.

Real-Life Story

My clients were the children of a senior aged 78. She had been placed at a Continuing Care Retirement Community (CCRC) that offered Independent Living, Assisted living, Assisted living with a memory care unit, and Skilled Nursing care. She had a lovely apartment in the independent living area that required an entrance fee of more than $200,000 when she moved in.

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When you have completed the daunting task of choosing the right senior living community for your loved one, your next mission will be to prepare for his/her move. It is very likely that the senior will be moving to an apartment or room that will be much smaller than his/her current living arrangement. Decisions will need to be made as to which items the senior will discard, donate or keep. All of us tend to have difficulty parting with “keepsakes” to which we have emotional attachments; accordingly, it may be a wise decision to utilize the services of a professional organizer when your senior moves.

Sue Becker is a Certified Professional Organizer in Chronic Disorganization. She has worked side by side with my senior clients (including those with dementia) to help them with the highly emotional task of sorting through years’ worth of keepsakes and papers and deciding which items to keep.

Keepsakes: Turn Your Muddled Mess into Meaningful Memories

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Assisted living communities that have a memory care unit are supposed to be adequately staffed with assistants and aides who are educated to deal with the behaviors of dementia residents. The habits of these residents can often be repetitive and endanger the resident if they are not closely watched. Many residents “sundown” in the evening, meaning they may often become more confused and agitated at this time. In my opinion, the caregiver ratio in these sorts of units at night should be no less than 1 aide to 8 residents, when residents with dementia, whether ambulatory or not, can become very agitated and even combative. The “powers that be” at some senior living communities will dispute my ratio, contending that they only need to staff according to long-term care regulations. This month’s real life story will outline the consequences of understaffing.

Real-Life Story

I was recently hired by a client who was forced to place her memory-impaired relative in an assisted living community’s memory unit. The relative had been living in another retirement community that was not equipped to care for residents with memory issues. When the staff at the original community witnessed the relative dragging a bag of laundry up the hallway in the wee hours of the morning, the staff arranged to have her taken to the local hospital’s behavioral unit for evaluation. Apparently, this had not been the first incident of questionable behavior. When the evaluation of the relative was complete, my client was informed that the retirement community could not handle the relative’s behaviors. Therefore, my client had to place the relative in an assisted living community that had a bed available in its specialized memory unit.

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One of my current clients is a former medical professional who has decided to donate her body to science upon her death. She therefore enrolled as a member of a local anatomical gift association. As her Power of Attorney for Health Care, I was assigned the task of pre-arranging for the disposition of her body. My client’s enrollment card stated that arrangements needed to be made in advance with a funeral director to transport the body to the location of the anatomical gift association when the time comes.

Upon making a telephone call to a local funeral home to get a price for transportation of the body, I was shocked to be quoted a price for more than $1,600, along with a $350 cremation fee. Since the quote sounded high, I called the anatomical gift association to be certain that I understood all of the stipulations. When I had a discussion with the association’s representative, I was informed that every funeral home has the right to charge differently for its services. I was also informed that if the anatomical association accepts the body, then cremation of the remains is free. If the body is not accepted, i.e., is diseased or in unacceptable condition, the association would charge $370 for the cremation of the remains. The association’s representative gave me the name of two other funeral homes and recommended that I get quotes from them.

When I called the second funeral home, I was informed that the cost to transport the remains would be $1,150, with a $350 cremation fee. Although the price was better, the funeral director’s demeanor was so unfeeling that I wrote him off immediately. The second funeral director quoted me a fee of $850, and there was no cremation fee whether the anatomical society accepted the body or not. The deal sounded a little too good, so it made me wary. Last, I contacted the funeral director who handled by late husband’s services, because he was a very easy going man who made my life easier during a very difficult time. His price was $650, plus a $350 fee for cremation if the body was rejected. While his transportation quote was even lower than $850, I knew that I need not be wary based on my firsthand knowldege of his services and demeanor.

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And old saying observes that “Beauty is only skin deep,” but I believe both beauty and better health begin inside and out. Here’s one example why.

I serve as a Geriatric Care Manager for a woman in her late 80s who has no family. Although I regret to take her outside during the cold weather, her medical appointments are a necessity that cannot be avoided. I’ve thought about how tough the frigid Chicago weather can be on anybody’s skin. Since I know my client’s medical history, I keep the following things in mind as part of her elder care planning:

Since she is over 85 years old, her skin is very fragile and rather thin. Therefore, she is subject to two skin conditions:

1. Seborrheic Dermatitis, a skin inflammation that is characterized by areas of dry, itchy flakes that are normally found in oily areas such as the scalp. The condition becomes worse during the cold weather. The condition is caused by yeast that activates skin irritation in cold weather.

2. Psoriasis, another skin condition that appears like a red outbreak with a dry patch on the top. It can appear just about anywhere on the body, but emerges mostly on the elbows, knees, and scalp. I have often seen the psoriasis flare on my client’s legs, and during the dark winter weather, it is much harder to clear up. It is much easier to get the outbreak to diminish when the skin is exposed to some light. The dermatologist treats the outbreak with a combination of topical steroids and an ointment called Calcitrol.

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Happy Holidays to you and your loved ones!

While the holidays can be a time of joy, they are also a time when extended family gatherings may provide us with occasion to notice that an older loved one’s health is deteriorating. As families reunite, celebrate the season, and take stock of the year gone by, they sometimes reflect on the passage of time – and begin to recognize how it might be affecting a senior member.

A sense of fear or worry — exacerbated, perhaps, by the darker winter weather – can then lead families to make rushed and hasty decisions about senior care or senior living options. Later, they hire me when they realize they have made an error.

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According to the National Institute on Aging (NIA), Alzheimer’s Disease is now the most common form of dementia among older persons. Dementia is marked by serious decline of one’s cognitive abilities — that is, the ability to think clearly, remember information, and engage in critical reasoning. More than the occasional “slip of the brain” that all of us experience from time to time (like forgetting where we placed our house keys or when a friend’s anniversary is coming up), Alzheimer’s Disease involves significant damage to the brain itself.

As the NIA explains, the brains of persons with Alzheimer’s Disease will exhibit abnormal tissue clumps (known as amyloid plaques) and/or tangled bundles of fibers (known as neurofibrillary tangles). A third main characteristic of the disease is the loss of connection between neurons, or nerve cells, in the brain.

The US Centers for Disease Control and Prevention report that as many as 5 million Americans suffer from Alzheimer’s Disease. More than half of all Americans know, or know of, someone with Alzheimer’s. The disease is believed to affect some 35 million people worldwide. According to the Global Burden of Disease Study, worldwide deaths from Alzheimer’s disease and other dementias more than tripled between 1990 and 2010. This may not be altogether surprising, as nations advance and more and more people live longer lives.

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In my last blog post, I talked about my client who is an 86 year old woman and is currently experiencing some issues with her teeth. Here is a summary of the story, some details that I didn’t share in the last blog, and how it ended.

As her Power Of Attorney For Health Care and senior living advisor, I had eagerly arranged for her to see the dentist who visited the assisted living memory care community where she resides. The upper denture had fallen out of her mouth. The nurse at the facility told me that it was a problem that needed to be addressed by a dentist.

After I arranged a visit with the dentist who serviced the facility, I was told by him that the remaining teeth in my client’s upper gums were all infected. The infection could spread to other parts of her body. When he discussed his treatment plan, I perceived them to be extremely complex. He wanted to extract 9 of her upper teeth (himself), conduct 9 house calls, complete two cleanings, and build a new upper denture. When I reviewed the pre-treatment plan he sent me, I was mortified when I saw the bottom line price was $7,800.

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I am currently in the process of assisting one of my clients who is having issues with her teeth She is 86 years old. I was appointed as her Power of Attorney For Health Care. Recently, the nurse at the assisted living community where she resides informed me that her upper bridge had fallen out. It wasn’t something that could be fixed with a tube of Poligrip. It may have fallen out due to her experiencing some weight loss.. The nurse said she needed to see a dentist. I thought it was fortunate that the assisted living community had just announced the appointment of a new dentist who would visit the community, rather than having the resident travel to his office. Because it seemed so convenient and I didn’t want to agitate her by transporting her to the office, I quickly made an appointment.

After a conversation with the dentist, I requested a pre-treatment estimate for the future dental work. I was told that he was unable to do further work at the assisted living community because a set of x-rays needed to be taken. Furthermore, she had 9 teeth on the top that needed to be extracted. Her lower teeth needed to be deep cleaned. He wanted to build a new upper denture and charge for two adjustments. The bottom line costs would be close to $7,700. My heart sank when I saw the figure.

I called the dentist and asked if there was any financial relief available in his figures. His answer was that he could offer a payment plan but no rate reduction.

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In the past several weeks it seems like I have been deluged with cases involving senior citizens who need to give up there driving privileges. My own Mother is 91 and still independent. Yet, she had enough common sense to relinquish the keys when she realized her age and the effects of her medications could cause her to have an accident. We live in such an auto-dependent society that most seniors don’t take charge of the fact that memory impairment coupled with the effect of medications can impair visual -spacial abilities, reaction time, and concentration behind the wheel.

As a senior living advisor, I have collected copies of the transportation schedules from over 400 communities. Many of the retirement communities offer transportation options that are quite flexible and could be a saving grace in a child’s quest to encourage a parent to stop driving. My REAL LIFE STORY exemplifies how retirement community transportation may help in that regard.

REAL LIFE STORY

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