Dementia and Covid

I think we all know that this experience will change how we live, work and play. For many of us that work primarily with older adults, we are seeing how some of the changes may make growing older better for all of us. I look forward to these changes with hope, even though right now, things are more challenging to manage as we adapt to physical distancing.

In the past two weeks, my neighbors and I have all realized that a couple living on our street is in dire need of support. The woman has been knocking on my neighbors door (she is a doctor) at all hours of the day asking for her to check her heartbeat. There has been an EMT visit (the man fell down the stairs), and someone also called the police.

The reality is that none of us can help someone who doesn’t want or recognize they need help. There have been calls to their son who at least helped them set up support from a home care service. There is only so much you can do for your parents who believe they are fine and decline help. The son lives states away.

Yesterday, the home care assistant didn’t know when the woman left the home. When my neighbor took her back home, the home care assistant yelled at her about leaving.

For those of us who are caring or have cared for someone with dementia, we recognize that while they may not remember a conversation, they do seem to hold onto emotions. I am guessing it won’t be long before my neighbors insist the home care assistant gets fired. Who wants someone coming into their home and yelling at them?

We are in a difficult time and many of those performing the duties of home care are not paid well and are putting their lives at risk. However, we also need to find ways to ensure the person in our loved ones homes are trained to help them and I’m afraid that some families are not getting the right support.

So what can you do if your family is in this situation?

  1. Randomly call your loved ones and even have them just leave the call with the line open* so you can hear what is going on in the home and how your loved one(s) are being treated … and how they are responding. If you hear something of concern, reach out to the home care agency and ask for them to address it with the caregiver. I cycled through a variety of individuals before we found the right fit for my mom.
  2. Contact an Aging Life Care Manager. These professionals are trained to help find the right care and be the onsite advocate if you are unable to travel to your loved one. They are not inexpensive, but when it comes to the service and support, I have found they are worth every penny.
  3. Move your loved ones in with you, or move in with your loved ones. There are a few families that have made this choice because they felt it was the best decision for them. This can be a huge hardship and commitment.

    Just know you will make the best decision you can with the information you have. Be at peace with the difficult choices you are and will be faced with. Your loved ones are lucky to have someone in their life watching over them when they need it. Reassured.

*Your loved one doesn’t understand your request? You could ask them to put down the phone and go get something, like an Aunt’s address or phone number because you want to send them a note. Be creative.

Aging in Place and Social Distancing

I am thankful that right now I don’t have to balance my children’s needs, my client’s needs, and my aging parents. My parents have both taken a celestial departure from this earth, but in just imaging them being around now … I feel my chest tighten.

I am working with several families who have a loved one that someone from my company works with in the metro-DC area. Our goal is to support our clients by assisting, managing in tandem, or by just handling the day-to-day financial matters (bills, home maintenance, long term care and insurance claims). After caring for two parents who had different types of dementia, I am very attuned to how much it means for them to live their life and manage their affairs.

So here we sit with several clients who still live alone in their homes. Some have stopped all external visits from health care managers, cleaning services, and personal care assistants while others doubled down and now have 24/7 help and care in their home.

There is no right or wrong. There is just right for each individual.

The initial two week social distancing came and went. Now we are looking at near isolation for some or escalating care expenses for possibly three months. I am curious to see how we all emerge and adapt after this experience.

What I have noticed in working with adults with cognitive disabilities is that the more they interact with others, the higher they function when we sit with them to do basic bill pay tasks. However, most of those isolated at home are now getting regular calls from the family, and are having to manage in their home all on their own. In calling many of them regularly, they are doing fine and have managed to adapt to our virtual support.

Will any of us win this experiment? Will those on their own emerge stronger after showing us all how they can manage? For those that could not manage on their own, will they do better than those in communities when it comes to exposure to Covid-19?

All I know is that we are all doing the best we can with the information we have at this time, and within the resources we have at our disposal. We may just see how well our American ingenuity shines at a time when modern medicine can’t protect us.

I’m looking forward to being able to see this one in my rear-view mirror. Wondered.

The Covid-19 Scams Begin

The Office of the Attorney General in Virginia just sent out a notice warning the community of coronavirus in-home testing scam.

A resident of Virginia Beach contacted their health care company to verify that it was them offering in-home visits for coronavirus testing. The scammer called the resident and told them they may have been exposed to someone with coronavirus (COVID-19). The caller then asked to come to the resident’s home to conduct a test.

The resident was appropriately suspicious and contacted her health care company. They confirmed this was not something they are doing. It was then reported to the police.

As we are adjusting to many changes in our own lives, we need to still be on alert that the scammers seem to be swift and nimble adapting. My 17-year old said she almost fell for an online shopping site with styles she loved and prices she could not believe. Before she started to order she googled the business and found no reviews or ratings — but then found a story about how many “online retailers” are popping up in hopes of a quick scam from unsuspecting online shoppers. Warned.

Two things you can do today if no power of attorney is in place.

Please know that I am not a lawyer, but was a caregiver to my parents for over five years and offer this advice as a practical end-around to frustrations I faced trying to use the legal tools to help them.

While my parents listed me on their power of attorney, I had a devil of a time getting banks, insurance companies, and financial services firms to recognize it. It was less than 2 years old and Virginia has a statute in place that frees them of liability if they do recognize it (my simple non-lawyer explanation).

There are simple ways to set up a safety net
for loved ones.

Instead of spending more hours fighting them (they received it but then didn’t do anything and then I would languish in their phone trees on hold), I worked with my parents to set up online access. In most cases I could do most things for them online.

As we enter this next phase of novel coronovirus and state and federal mandates, I am worried for the large numbers of older adults who don’t have someone who can step in and pay bills should they become sick.

Some things you can do today to prepare include:

  1. Go to the bank with your loved one, and sign their power of attorney. It will put you on the account immediately. They may also offer to add you to the account, but this could be an issue since then you become a “joint account holder” that brings other possible complications and risks.
  2. Set up online access to the account. You can do many things with online access and at minimum it will allow you to monitor the account or step in and help pay bills if your loved ones needs help.

It’s a shame that so many American’s do not have powers of attorney (POA) in place. I believe it should be a right of passage upon turning 18 to set up your first POAs. I did pay for my son to set up a Durable Power of Attorney, and a Medical Power of Attorney for his 18th birthday. I do hope I never have the cause to use them.

We are in strange times. I hope this gives you some ideas of how you can help should you need to step in and help a loved one who doesn’t have their estate plans in place.

If you have the time, now is a GREAT TIME to create POAs, and get a Will in place and have a discussion about the finances. To find a local elder care attorney, you can visit the National Academy of Elder Law Attorneys. Recommended.

How are you dealing with “social distancing” and caregiving support?

I’m involved with many families who have a single adult parent with mild to moderate cognitive issues who wanted to stay at home. Now we are trying to manage care and minimize risk. What are you doing?