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Knowing the type of Dementia Helps Everyone

I didn’t handle the diagnosis of my parent’s well. I thought that hearing a doctor tell them they had dementia would suddenly make helping them easier for me. I finally realized that it was equally devastating to my Mom every time she was told.

For a large majority of individuals with vascular dementia – the type that comes after a stroke – they are unable to recognize their loss. My Mom had no physical changes, and for the first few months thought I was making up the fact that she had a stroke. The medical term is Anosognosia and I wish I knew and understood this when my Mom was diagnosed. She was medically unable to perceive that she had difficulty with her thinking and memory.

In the years since I lived through caring for two parents with dementia, I have found many individuals that don’t understand why a diagnosis mattered at all.

A recent story on NPR Is It Alzheimer’s Or Another Dementia? The Right Answer Matters reinforces the need to get a diagnosis. Apparently, most people default to the belief it is Alzheimer’s, and having some insight can also help the care partners manage better.

I have had a long-standing discomfort with the share of voice Alzheimer’s has taken. First and foremost is because most people don’t even know it is the most common form of dementia. I didn’t realize it until my Mom was diagnosed with Vascular Dementia, while my Dad was diagnosed with Alzheimer’s.

What I have learned is that the primary types of dementia all come with varied behaviors, risks, possible treatments and care plans. One form of dementia comes with symptoms that present more as a personality change than symptoms of dementia. In general, changes in behavior, mood, and memory should all be discussed with your primary care physician. Knowing more can help everyone and I hope you will help learn more should you be concerned about your own health changes or those in a loved one. Encouraged.

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Working in Tandem as Dementia Progresses

I was really frustrated when I knew that my parents were having trouble managing their household but refused to accept any help. They did not recognize they needed help which is very common for people diagnosed with dementia. And I also recognize I probably came in too strong.

As the disease progressed, my parents started asking me to help. I had backed of and started visiting without an agenda. When asked, I would work in tandem with them or would accept the assignment and transition to a new topic depending on how they presented the task. If we started to work on a task and they grew fatigued or anxious, I would usually ask if we could take a break and go get a cup of tea or take a walk. I had to change so I adapted.

You have probably heard the expression “meet them where they are” but while it seems so simple a concept, it’s often hard to adapt a familiar pattern. As I adapted to be a better family care partner, I started to recognize all the things I was losing. That helped me recognize how difficult it was for my mom and dad as they were also loosing to the disease.

As I work with others diagnosed with varied forms of dementia, it’s much easier for me to meet them where they are. I now see how easy it is to work with them to pay a bill, organize tax papers, and even help them plan for an upcoming luncheon they have attended for years.

My hope is that they can enjoy where they are a little longer. Learned.

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The allure of a ringing phone

Living in the DC metro area has made me numb to politics. However, stories like the recent one FCC threatens carriers with ‘regulatory intervention’ over robocalls are hopeful. However, that means there is still a lot of scammers out there making calls and reaching our loved ones. And too often they are very successful — which is why they keep calling.

The tools I implemented in my own home as well as for my clients no longer work. Many of the calls are sneaking through the protections that used to be so effective.

The reality is that now the ONLY defense is to NOT ANSWER THE PHONE. If you don’t recognize a call, let it go to voicemail. When you listen to voicemail, be careful to discern who is legitimate. That part is tough.

What I see in the homes of my clients that are isolated is how excited they are to hear a ringing phone. Regardless of my recommendations, they generally just answer. The insult to injury is how difficult it is to contest and win the credit card charges when we later find out which ones were successful.

If your loved one is still at home and you can, you might consider posting a note on or near the phone:

  • The phone scammers are smart and crafty.
  • Don’t answer unless you know the caller.
  • Never give out ANY of your personal information.
  • Don’t give anyone your Credit Card numbers over the phone.
  • Call me if you need some help following up on: _______________________

Sometimes, all you can do is work to help defend those that need help. Please let me know if you have any solutions that are working for you and your loved ones now. Interested.

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I arrived to find my Dad on the floor

My girlfriend was leaving to visit her parents and asked for a copy of the MemoryBanc workbook to help her mom get a handle on the accounts and finances. I gave her two and suggested she show up to her parents home with the plan that they would work through the book together. Most of our parents won’t appreciate us showing up and telling them we think they are disorganized so make it a project you do in tandem for your individual households.

After her mom picked her up at the airport, they return home to find Dad on the floor. This isn’t the first time.

She shared that there was no way her mom could have helped get her dad up, she is younger and in better health than dad but is now exhausted caring for him and growing frail. Her dad is adamant that he wants to “age in place” and won’t considering moving to a life care community.

If you are in a similar situation, here are some things to consider:

  1. If your parent is falling and can’t get up, don’t continue to run over and help them if you are local. Tell them to call 911. I say this because I was local and kept driving over when this happened to my parents. It finally dawned on me that I was enabling them to stay in their home by showing up and making light of the issue when neither of them was hurt in the process. We were lucky that Dad didn’t fall on mom, but in many cases the caregiver is the one that ends up getting hurt. My parents finally recognized it was a big deal that they had to call 911 and made changes.
  2. Suggest your parents get on the wait list to a community of their choosing. They don’t have to move in, but for those that get on a wait list to a life care community, they usually have the ability to go there if they need Rehab or Skilled Nursing. In general, when you are being checked out of the hospital, you only have a few choices of the stand-alone facilities that have an open bed (versus have good reviews). The Life Care Communities generally have better ratings and most importantly, you are choosing where you would like to go rather than having to go to the bed that is open and maybe further away from family and friends.
  3. Ask the individual who is falling if they realize that their next fall could harm their loved one. Most people think of their issue as something that only impacts them and don’t realize that their next fall could start a chain reaction that puts their loved one in the hospital and will also impact their options for daily living assistance.

Falls are reported as the leading cause of death from an injury for older Americans. One of every five people who breaks a hip after age 50 dies within a year. According to the CDC, three quarters of those with hip fractures are women.

This is a tough situation and there are a lot of ways to assist and manage toward safer choices. Sometimes, our loved ones don’t recognize the risk to those they love if they don’t make some changes. Experienced.


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Brush away Alzheimer’s?

I can hardly wait until they have some proven options to prevent and even cure Alzheimer’s … and maybe even all of the other forms of dementia. It’s so devastating to the individuals and their loved ones.

It was hard to witness the changes in my parent’s and it was sad to slowly lose those beloved traits and quirks their dementia’s stole away.

I do see some older adults who start to skip the health maintenance tasks they regularly followed as they age. Some make sense … like the colonoscopy. Is there an age where you might stop getting this screening?

I do know my parent’s no longer wanted to visit the dentist. I fear the day when my current dentist retires. Seeing him and everyone in his office is like visiting dear family friends. Will I some day feel the same way?

Could dental hygiene be one of the best prevention’s? If you haven’t seen the news, here is a link to a recent report on the study. Hoped.

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Simple Steps to Safe Guard a Loved Ones Finances

After caring for two parents with dementia, I remind myself how much the checkbook meant to my mother. She had always managed the household finances and the suggestion that she was unable to manage a checkbook safely was something that needed to be left unsaid. I found that out after I said it a few times. ; <

The biggest problem I faced was a lost purse that contained the checkbook. She thought she left it in a cab, a store, at a bridge game … I couldn’t manage the hours each week spent looking for her purse. Today you can at least get a tile which would have been immensely helpful in keeping track of her handbag, but it wasn’t an option yet.

There are options to consider if your loved one would like to continue to manage their purchases:

  • Open up a new checking account and fund it with a small amount of money that can afford to be lost. I did this for my Mom. She had her checkbook, and I could move money into her account in small amounts as it needed to be replenished. If the checkbook never turned up or she had a check stolen we could easily close the account.
  • Consider setting up a TrueLink card. It is basically a credit card where you can set up limits on how much can be charged as well as products and services that it won’t fund. There is a fee for it, but the small expense is worth the money it will most likely save in potential losses.

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

What I struggled with was that this was one of the few remaining freedoms for my mom. She could no longer drive, or run the bridge games she loved, and that checkbook gave her an empowered sense of self. Now as a Daily Money Manager, I see all the ways that people are trying to get at the money of my clients.

Ultimately, someone needs to be vigilant about minding the finances as well as considering how to layer in these protections. A few bad apples spoil the lot. Reported.

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The law in Virginia to protect elders fails us all.

This is a follow up to my last blog about being subpoenaed in an elder fraud case. Sadly, the commonwealth attorney and police detective both know that the woman stole money money from my client. At 91, she suffers from Parkinson’s but can walk on her own, feed herself (and help feed others), and you can often have pleasant conversations with her and she initiates questions back to you. She also has the cognitive issues that can come in tandem with Parkinson’s. When I first met her she presented with more short-term memory loss and had organization issues. The Parkinson’s was diagnosed a year after I stepped in to help with the daily money management and bill pay support.

The caregiver admitted to the detective she asked for the money. My client apparently told the detective the woman asked her for money. Taking money from clients is against the employment agreement she signed in addition to being an ethical failure.

I do know that my client had no idea where the checkbook was located in her apartment, nor could she have written the check on her own. The caregiver rooted through my clients belongings to find the checkbook.

I studied the check and it was easy to see that my client started to write the check (shaky, sloping hand-writing), but then someone else finished writing the check. I had samples to show that the way the check was written was very different (she wrote dollars and cents which my client never did). I figured a handwriting expert would not be on hand, but as a Daily Money Manager I could point out how I could tell that someone else finished writing the check.

After waiting for three hours for the case to be called, the attorney tells me (and the community care manager who was also there to testify) that only if we can confirm that my client didn’t understand that writing the check took money from her account would we get a conviction. So they DISMISSED the case. It will be VERY hard to convict someone based on how the current law is written. You will see the statute below which also illustrates the lack of knowledge around dementia.

Two good outcomes from this include:
1) The charge is now on her record so hopefully it will dissuade other
home care agencies and communities from hiring her again.
2) She is paying back the money.

The reality for those of us that have loved ones with dementia is that we know one could NEVER truly say they don’t understand that the money came from their account until very late stages of the disease. We witness a variety of ways their intellect shines through this horrible diagnosis.

So the LAW will fail us … at least in the Commonwealth of Virginia. I am putting together best practices to consider now that we know our hands are tied when we try to prosecute those who would take advantage of older adults with cognitive issues. Even if we can’t get the conviction, it is in our best interests to always report it to the police. The fighter in me is just getting going. Alerted.

§ 18.2-178.1. Financial exploitation of mentally incapacitated persons; penalty.

A. It is unlawful for any person who knows or should know that another person suffers from mental incapacity to, through the use of that other person’s mental incapacity, take, obtain, or convert money or other thing of value belonging to that other person with the intent to permanently deprive him thereof. Any person who violates this section shall be deemed guilty of larceny.

B. Venue for the trial of an accused charged with a violation of this section shall be in any county or city in which (i) any act was performed in furtherance of the offense or (ii) the accused resided at the time of the offense.

C. This section shall not apply to a transaction or disposition of money or other thing of value in which the accused acted for the benefit of the person with mental incapacity or made a good faith effort to assist such person with the management of his money or other thing of value.

D. As used in this section, “mental incapacity” means that condition of a person existing at the time of the offense described in subsection A that prevents him from understanding the nature or consequences of the transaction or disposition of money or other thing of value involved in such offense.

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