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Visiting Mom During the Holidays and Something is Not Right

The holiday season is here, and you may have visited, or will be visiting an elderly loved one. Are things different than the last visit? Are you seeing things that don’t seem right?  How do you know if something is wrong?  Below are some areas to consider (note feminine emphasis for ease of writing, but also applicable to elder males):

Personal Hygiene – Does she shower less frequently, wear dirty clothes, or have neglected teeth? Are there any injuries that you can see? Is there a urine smell? Was she always fastidious about her wardrobe, and now is dressing in a less put together way?

Forgetfulness  – Have you seen stacks of unopened mail or newspapers, unpaid bills, unfilled prescriptions or missed appointment slips? Letters from credit card companies with reminders to pay or late payment charges can be a sign.

Behavior – Does she repeat questions? Can she carry on an extended conversation? Does she refuse any suggestion or does she just agree with everything said? Does she retain what was said? Are there any apparent mood swings? Is she unusually loud or quiet? Is she angry?

Relationships – Do friends call? Have relationships changed in such a way that friends and neighbors have expressed concerns? Has she quit socializing or participating?

Medication and Health Management – Can she take medications without supervision? What are the medications? Who goes to the doctor with her? Is she going to the doctor at all?  Does she refuse to go?

Eating Habits – Does the refrigerator contain adequate food? Is there any spoiled food present? Have her eating habits changed? Any unexplained weight loss? Has she missed meals or have a lack of appetite?

Shopping or buying things – Do you see evidence of excessive shopping or ordering? Is the mail full of charitable letters, a sign that she is giving money to anyone who asks?  Is she having difficulty making change or writing checks?

Home Maintenance – Is it in disrepair? Is dust accumulating where (at one time) she was a great housekeeper? Is trash accumulating?

Kathleen S. Allen, LCSW, C-ASWCM, is a Geriatric Care Manager and Elder Care Consultant in Northern Virginia. She works with seniors and their families to help guide them through the challenges of aging and caregiving.

 

This article was first published in December 2011, and has been revised for this posting.

What Would You Do?

This is a question I hear fairly frequently. Family caregivers come to me looking for solutions to their caregiving challenges, and often this question surfaces. “If this were you, what would you do?”

Recently, I was reminded of this question after attending a one day conference with Teepa Snow, a national expert in communicating with those with dementia and Alzheimer’s. It was a day I will not soon forget. She was engaging, interesting, entertaining, and so very informative. I could not get over how many notes I took, as she showed the large audience many techniques in having a successful communication with their dementia and Alzheimer’s patients or family members.

So, if someone came to me looking to understand how to communicate with their loved one who has Alzheimer’s, I would share what I know, and I would also recommend they look online for Teepa Snow. She is the most informative expert I know of in this area of Alzheimer’s.

Here is a link to her website. Be sure to check it out.

September is World Alzheimer’s Month

Each September, the Alzheimer’s Disease International releases a report of the status of Alzheimer’s Disease throughout the world. This year, their report was entitled “The Global Impact of Dementia.” In it, they document the global prevalence, incidence, cost and trends of dementia in the world today. Some interesting facts include:

  • In 2015, there are estimated to be 46.8 million people worldwide who are living with dementia.
  • This number is expected to double every 20 years, and will reach 131.5 million in 2050.
  • Throughout the world, there is estimated to be one new case of dementia every 3.2 seconds, or 9.9 million news cases.
  • Of the number of new cases of dementia:
    • 4.9 million are in Asia
    • 2.5 million are in Europe
    • 1.7 million are in the Americas
    • 0.8 million are in Africa.
  • The global cost of dementia care is $818 billion in 2015, and will reach $2 trillion by 2030.
  • Global dementia care, if it were a country, would be the 18th largest economy in the world.

These are pretty grim statistics, especially in light of the fact that there is no effective treatment, no cure, and no proven way to prevent Alzheimer’s or dementia. However, if you are inclined to take part in the fight against Alzheimer’s or dementia, there are studies you can volunteer for. Even if you do not have a personal or family history of these diseases, you may be needed in a study. If interested, contact the NIA’s Alzheimer’s Disease Education and Referral (ADEAR) Center at 1-800-438-4380 or visit www.nia.nih.gov/alzheimers/clinical-trials.

Tips for Working with Caregiving Aides

David Troxel, the well-known author of the “Best Friends Approach to Alzheimer’s Care,” and an Alzheimer’s caregiver himself, tells a story of how he taught his mother’s caregiving aides how to prepare afternoon tea.

This article first appeared at BrightFocus.org and can be read in its entirety here.

Update to the Medicare “Observation Status” Problem

Several months ago, in September 2013 specifically, I wrote about the issue of being under “observation status” when in the hospital.  A problem occurs when a hospital deems a patient “under observation.”  Such a status means just that.  What it does not mean is that the patient has been admitted to the hospital.  The patient may be in the hospital, on a unit, and in a hospital bed in a regular room, even receiving all the routine procedures of a hospitalization, but if they are “under observation,” it can create a problem, especially when the discharge plan is to go to short term rehab in a skilled nursing facility.  Unless the patient was “admitted,” and was in the hospital for at least three days, the rehab stay currently will not be covered by Medicare.  The person’s only option is to pay privately for the rehab stay, or go directly home, if that is possible.

Now, though, efforts are under way to change that.  Congress is addressing this issue through the “Improving Access to Medicare Coverage Act” (HR 1179 and S 569).  If passed and signed into law, the time spent in observation will count toward the three day hospitalization requirement.  Let your representatives know if you support this bill.