Archive for the ‘Alzheimers’ Category

Demand for Caregivers Increases

Wednesday, September 11th, 2013

A new study by the Pew Research Center and the California HealthCare Foundation found that the number of adult caregivers of family members has increased from 30 percent to 39 percent in the past year. The sluggish economy, an aging population and an increase in chronic illnesses all have contributed to an increased need for caregivers in the home. And more than ever, those family caregivers are turning to the internet for support and information.

Grandm_GranddThe U.S. population in 2000 included approximately 12 percent of adults 65 years and older; by 2020, adults 65 and older are expected to make up at least 19 percent of the population. The increased “graying” of the country means that more comprehensive services for elders and their caregivers, both professionals and family members, are an ongoing concern. Most of the adults who are caring for a family member – two-thirds – are either caring for a parent or a parent-in-law, researchers say. Caregivers typically are doing everything from managing finances to shuttling the elderly parent to medical appointments, and more.

Another cause for concern is that more seniors than ever before are living with complex chronic medical conditions, and living longer. Seniors are relying on family members to help with their medical issues, in large part due to the sluggish U.S. economy. More households are attempting to manage their care with limited funds and resources and caregivers are turning to the internet for information on illnesses, symptoms, medications and treatment. The study found that more than 70 percent of caregivers surveyed reported that they research issues online. Information on medical issues and the support of social media have never been more important to caregivers, researchers say.

But the Internet is only one resource, and not as comprehensive as many caregivers need. According to a 2012 estimate by the AARP, 50 percent of caregivers for the elderly are delivering complex medical and nursing care in their own homes.

The bottom line? The U.S. health care system and the social system are both struggling to keep up with the demand for elder care. For now, that need is still being met primarily at home.

 

 

Visit www.elderlawnewyork.com for more information.

 

Traveling Tips for Families with a Loved One with Alzheimer’s

Monday, September 9th, 2013

If you have a loved one with Alzheimer’s or other dementia, you may be apprehensive about bringing your family member with you when traveling. However, with a little bit of careful planning, you and your loved one can enjoy a safe trip.

Before deciding on travel details, consider what would be best for the safety and comfort of your loved one with Alzheimer’s. People in the early stages of the disease often enjoy travel, but for some the experience is overwhelming. Keep your family member’s preferences and limitations in mind when choosing your transportation method. The best journey is one that does not unduly disrupt your loved one’s daily routine. A person with dementia is likely to prefer a destination that is familiar or that involves visiting loved ones.

Navigating airport security can be difficult for someone with dementia; if you must travel by air, consider informing the airline of your needs ahead of time. Even if a wheelchair is not necessary, it may be a good idea for your family member’s comfort and because you will have an airline employee to help you get around the airport.

During the trip, be aware of the fact that a change in environment can be a trigger for wandering, and take precautions. Also be sure to keep essentials on hand such as a comfortable change of clothes, all prescribed medications, snacks and drinking water. You should also bring important documents such as copies of any living will or advanced health care directives, health insurance cards, and doctors’ names and contact information.

For more information about our elder law services, visit www.elderlawnewyork.com.

 

How Nursing Facilities Can Be Welcoming to LGBT Residents

Monday, August 19th, 2013

Nursing homes have always had lesbian, gay, bisexual or transgender residents, but they have not always felt comfortable identifying as such, for fear of how staff or other residents might react. It is important for nursing facilities to be open and welcoming to LGBT residents, and to this end the Alzheimer’s Association has published a guide for long-term care facilities welcoming LGBT residents. The guide is also useful for LGBT elders and their families considering a nursing facility, to determine how welcoming it will be.

According to the Alzheimer’s Association, a facility should first of all assume that there are LGBT residents, and not assume that staff can identify them. LGBT residents cannot necessarily be identified by external characteristics and they may have past life experiences such as being in a heterosexual marriage or having children that do not fit common assumptions about LGBT people.

The association also recommends that nursing home staff ask residents about their sexual orientation in a safe and confidential way, in the same way that any other factual though potentially sensitive question would be asked. However, if the resident appears uncomfortable, the matter should not be pushed, and staff should remember that sexual orientation is just one aspect of a person’s identity.

The association recommends – and LGBT elders should look for – signs of welcoming in a long-term care facility. A facility can show that LGBT elders are welcome by prominently posting its non-discrimination policy, including same-sex couples in marketing materials, and including LGBT-inclusive images or messages in the lobby and other public areas. Forms should include relationship options such as “significant other” and “partner.” Staff should be trained on how to recognize and address the needs of LGBT residents.

When nursing facilities take these steps, it will be apparent to LGBT elders and their families that the facility is welcoming to them.

 

For more information about our elder law services, visit www.elderlawnewyork.com.

What to Do When an Older Loved One is Resistant to Care

Tuesday, August 13th, 2013

 

Caring for an older loved one can be a challenge, even more so if the family member is resistant to care. In dealing with this type of situation, it is important to understand the source of the resistance and how to encourage cooperation.

A family member who resists care, whether it is direct help by a loved one or professional care, is likely experiencing unhappiness due to loss of independence. Needing to be cared for involves a disruption of routine and loss of privacy, which can be disconcerting. An older family member may be feeling frightened of aging or feel guilty about being a burden on other family members. All of these factors can combine to cause a response that is understandable even if it is not very rational: resisting needed care.

An important part of dealing with resistance to care is knowing when and how to have the necessary conversations with your loved one. You should bring the subject up at a relaxed time when you will be able to take time to listen to each other. Be sure to ask questions about your family member’s needs and preferences. Even someone with Alzheimer’s or other dementia can express preferences. If your loved one is resistant to even talking about the care situation, try letting the matter rest for a while and bringing it up again later.

One effective strategy for encouraging cooperation is to suggest that a new type of care be introduced on a trial basis. Whether the change involves bringing in a home health aide or leaving home, much of the resistance may come simply from fear of the unknown. Once your loved one actually experiences the benefits of care, there may be less trouble accepting it. In the case of a home health aide, it can be useful to point out that this can help prolong independence.

Depending on the situation, it also may be helpful to have a professional such as a doctor, attorney or care professional explain the need for care and the benefits of a certain arrangement. Due to family dynamics, an older parent may be more likely to take the advice of a trusted adviser.

Resistance to care can be an enormous challenge. Communicating effectively with your family member can make all the difference.
For more information about our elder law services, visit www.elderlawnewyork.com.

How to Find a Senior Caregiver for an Adult with Alzheimer’s or Dementia

Monday, August 5th, 2013
Our guest blogger this week is Ken Myers, President of Morningside Nannies. – See more at: http://www.specialneedsnewyork.com/blog/#sthash.7I9XmaZ0.dpuf


Our guest blogger this week is Ken Myers, President of Morningside Nannies

As adults, we tend to take for granted an abundance of competency related normalcies that will one day begin to deteriorate, but there are many revelations that come with aging. One may wonder how our family members will find the proper person to take care of us when we are unable do so ourselves. How do our family members find the right person to take care of us when we are unable to do it for ourselves? The following is a list of considerations that need to be taken.

1. Experience – Though a person may have a substantiated educational background pertaining to the care of a senior with Alzheimer’s, someone with hands on experience may be better suited to provide for a person confronted with the ever-changing needs of their particular situation. You do not want to disregard education in total, but perhaps someone with more real time experience is better suited for the person that needs care.

2. Education – The positive value of a good education cannot be disregarded when considering a candidate.  A young person with a degree that is certified to care for seniors with disabilities may be adequate for your situation if it is not very complex. It will also provide that capable person with priceless hands on experience, enabling them to know what to expect going forward. At the very least the person will be prepared for the basic treatment of Alzheimer’s and/or Dementia and will likely be knowledgeable about CPR and First Aid. The latter is not guaranteed, so please ask.

3. Background Check – It is always smart to perform a background check on your caregiver and it should be a common practice. This will validate their credentials and prove useful in preventing an unfavorable situation when hiring live-in help. The downside to not preforming a background check is bottomless. This should always be done when considering care for a senior.

4. Trial Run – Impose a period of trial employment to gauge how well the candidate and the senior interact with each other day to day. Many adults will resist giving up control when it comes to personal care; it is natural to want to be independent. Grading how well a candidate performs under the pressures of resistance and aggression by the senior will help to determine if they are a fit for the job.

5. Caregiver Agency – There are many agencies that offer caregivers at varying levels of skill and education. These agencies have already prescreened, tested, and deployed these professionals to care for seniors in the past. Though these agencies tend to be more expensive, you can rest assured knowing that this candidate performs their job well and is proven.

It takes a great amount of patience and understanding to deal with someone with Alzheimer’s disease or Dementia. The person will need to be able to adapt at the drop of a hat and be able to care for us. You wouldn’t want to put someone who isn’t ready in that predicament, and many of us would rather not put our own family members through the frustration and anguish that comes with day-to-day care.

 

Author Bio:

Ken holds a master’s in business leadership from Upper Iowa University and multiple bachelor degrees from Grand View College.  As president of morningsidenannies.com, Ken’s focus is helping Houston-based parents find the right childcare provider for their family. When he isn’t working, he enjoys spending time with his three children and his wife.

 

For more information about legal services for seniors, visit www.elderlawnewyork.com.

Prepare as Soon as Possible After Diagnosis of Alzheimer’s Disease

Wednesday, July 31st, 2013

Though the diagnosis of Alzheimer’s disease can be a distressing time for the patient and his or her loved ones, elder care advocates say that it is critical they begin advance planning for financial arrangements and health care as soon as possible. Alzheimer’s is a progressive disease of cognitive decline, but it can last for many years. Putting plans into place early can help make a significant difference in how that time can be spent.

If someone suspects that there are memory issues or other cognitive concerns, they should see a neurologist, geriatric assessment clinic or memory clinic for testing. If there is a formal diagnosis of Alzheimer’s disease, the results will give a baseline which may help when charting out a plan of next steps.

A person with a diagnosis of Alzheimer’s disease should then work with an elder law or estate planning attorney to ensure that their legal planning is thorough. Documents to be addressed include health care documents such as an advance directive which explicitly instructs health care choices (sometimes called a “living will”), and a durable power of attorney for health care decisions. The financial documents to be developed include a will, a durable power of attorney for finances, and possibly a living trust.

An elder care lawyer or estate lawyer can also assist in mapping out the financial options available for care. Some people find that spending down their assets to qualify for Medicaid is the option for them, but those assets need to be released at least five years before applying for Medicaid. Many states now have some level of a partnership-eligible, long-term-care policy available to help individuals protect some of their assets while using Medicaid. The purchase of a partnership policy which covers as much as $250,000 of care may allow the patient exhaust benefits and qualify for Medicaid while still holding onto assets up to $250,000.Other financial concerns for people with an Alzheimer’s diagnosis include checking with their bank’s policy on power of attorney and whether they need their own forms. Some banks require that they have their own power of attorney forms on file, which may be difficult to procure later on.

 

For more information about our legal services, visit www.elderlawnewyork.com.

Elderly Care: When An Aging Parent Needs Emergency Care

Tuesday, July 16th, 2013

The American College of Emergency Physicians (ACEP) has released tips for the adult children of elderly parents who find themselves facing a medical crisis. The emergency room can be a daunting experience. These tips may make the experience slightly less stressful.

When possible, the caregiver or accompanying adult should bring to the emergency room a completed Medical History Form. The form should list any allergies, the medications the elderly person is taking, and both past and current medical conditions. This form should be given to the intake attendant.

In addition to the Medical History Form, have on hand a list of the medical health professionals the elderly patient sees, such as cardiologist, oncologist, etc. Have their names and contact information written down, as well as the reasons for their care and how long the elder has been under their care. Also include any information about recent surgeries, such as pace makers or hip replacements, and include complete insurance and identifying information.

The emergency physicians also suggest that any caregiver or attending adult bring a change of clothing and personal items, and should expect that the elderly individual will be admitted for overnight or extended care. While this may not happen, arriving prepared will save time and effort later. The items can always be left in the car “just in case.” Also, caregivers may wish to bring reading material to pass the time while the patient is waiting to be seen or for test results. Elderly patients make take longer than expected to have a complete workup, especially if they have multiple issues or complaints which must be investigated.

The ACEP also suggests that the caregiver clarify to the attending physician if the patient’s state of mind is altered or if he or she is confused. If the caregiver is given information and instructions, he or she should share that information with the patient; work to keep them informed and allow them to make their own medical care choices.

Many elderly patients downplay their symptoms when in the ER, doctors report. Be prepared and willing to clarify with additional information, if needed.

And long before that trip to the ER is a possibility, they say, consider discussing with the elderly parent about the possibility of their drafting a living will. When in the midst of tough decision-making such as when the condition is a life-threatening one, it can make a significant difference in how family members approach some choices that must be made.

 

For more information, visit www.elderlawnewyork.com.

 

Planinng for Life’s Unexpected Twists and Turns

Tuesday, June 4th, 2013

By Susan Yubas, Director of Business Development at The Bristal Assisted Living, Certified Senior Advisor, Founder of FYI Senior Living Solutions, Inc.

Most of us do not get around to having that all important conversation with loved ones, and if we do, it is at the worst possible time and under the most stressful conditions.

An acquaintance of mine in her early forties was recently hospitalized following an automobile accident in which there was no other car involved.  An otherwise healthy, active woman who was not texting or talking on her cell phone while driving, her husband and I waited to hear what could have been the cause.  Did she have a stroke, a seizure, a heart attack?

As we sat together, he asked “What if she doesn’t pull through?  Or has physical or cognitive issues?  What if she can’t go back to work? Can we afford to live on one income, especially if she needs help? We never talked about this.  We never talked about the “what if’s.” I don’t know what she would want me to do or what would be best!”

In my practice, I primarily work with older adults and their families as they prepare for and deal with the life transitions that happen with aging.  But, the reality is that planning is not age related.  Denial is just so convenient.   We have all the time in the world to “get to it” and we’re young and healthy.  We may get old, but will never be “elderly.”  If we are, there will always be someone around who knows what our wishes are. They will have our best interests in mind.   That person will also be able and willing to implement and execute whatever needs to be done and, of course, there will be enough money to pay for it all.

Or, we made a plan a long time ago and haven’t updated it due to “benign neglect.“ Since then, we’ve moved to another state with different regulations.  We’re no longer friendly with the person we named as Executor in our Will.  Documents may not be titled properly so that our wishes can be granted.  Then, a crisis happens, and you receive that call about a parent who has had a fall, a stroke, or an accident, and life will not be the same.

Several months ago, I met with a couple in their early 70’s at the request of their son who lived out of town.  He couldn’t get his parents to talk to him about their wishes and plans for the future, which they insisted, were all taken care of.  In the course of our conversation, I learned that they had, in fact, made plans for retirement long ago.  Since then, their circumstances had changed significantly,   but they had made no changes in their initial plan.  They were in good health and enjoyed an active, independent life.

Shortly after our initial meeting, the husband started to have problems with his eyesight.   The wife slipped on the stairs, fractured her hip and only wanted to recover at home.  Neither of them could continue to run the business they had built.  Previously capable parents were suddenly not able to think clearly due to the stress of the situation.  The children were angry at their parents for not thinking about how they would take care of each other or for what would happen to their business if they could no longer work.  They argued over what would be the best for their parents and who would be the child responsible for coordinating their care and transition to what would become their “new normal.”

Life does not always go as smoothly as we would hope.  However, when we take the time to plan in an organized and thoughtful manner, we can make difficult situations a little less difficult and hopefully avoid a crisis situation from occurring.

 

For more information, visit www.elderlawnewyork.com.

 

Alzheimers and Holidays

Wednesday, December 19th, 2012

Great entry from the Alzheimer’s Association — click here to visit the full article.

The holidays are a time when family and friends often come together. But for families living with Alzheimer’s and other dementias, the holidays can be challenging. Take a deep breath. With some planning and adjusted expectations, your celebrations can still be happy, memorable occasions.

Familiarize others with the situation

The holidays are full of emotions, so it can help to let guests know what to expect before they arrive. If the person is in the early stages of Alzheimer’s, relatives and friends might not notice any changes. But the person with dementia may have trouble following conversation or tend to repeat him- or herself.  Family can help with communication by being patient, not interrupting or correcting, and giving the person time to finish his or her thoughts. If the person is in the middle or late stages of Alzheimer’s, there may be significant changes in cognitive abilities since the last time an out-of-town friend or relative has visited.  These changes can be hard to accept. Make sure visitors understand that changes in behavior and memory are caused by the disease and not the person. You may find this easier to share changes in a letter or email that can be sent to multiple recipients.

Here are some examples:

  • “I’m writing to let you know how things are going at our house. While we’re looking forward to your visit, we thought it might be helpful if you understood our current situation before you arrive.
  • “You may notice that ___ has changed since you last saw him/her. Among the changes you may notice are ___.
  • “Because ___ sometimes has problems remembering and thinking clearly, his/her behavior is a little unpredictable.
  • “Please understand that ___ may not remember who you are and may confuse you with someone else. Please don’t feel offended by this. He/she appreciates your being with us and so do I.”

For more ideas on how to let others know about changes in your loved one, join ALZConnected, our online support community where caregivers like you share tips on what has worked for them.

Adjust expectations

  • Call a meeting to discuss upcoming plans.
    The stress of care-giving responsibilities layered with holiday traditions can take a toll. Invite family and friends to a face-to-face meeting, or if geography is an obstacle, set up a telephone conference call. Make sure everyone understands your care-giving situation and has realistic expectations about what you can do. Be honest about any limitations or needs, such as keeping a daily routine.
  • Be good to yourself.
    Give yourself permission to do only what you can reasonably manage. If you’ve always invited 15 to 20 people to your home, consider paring it down to a few guests for a simple meal. Let others contribute. Have a potluck dinner or ask them to host at their home. You also may want to consider breaking large gatherings up into smaller visits of two or three people at a time to keep the person with Alzheimer’s and yourself from getting overtired.
  • Do a variation on a theme. If evening confusion and agitation are a problem, consider changing a holiday dinner into a holiday lunch or brunch. If you do keep the celebration at night, keep the room well-lit and try to avoid any known triggers.

Involve the person with dementia

  • Build on past traditions and memories.
    Focus on activities that are meaningful to the person with dementia. Your family member may find comfort in singing old holiday songs or looking through old photo albums.
  • Involve the person in holiday preparation.
    As the person’s abilities allow, invite him or her to help you prepare food, wrap packages, help decorate or set the table. This could be as simple as having the person measure an ingredient or hand decorations to you as you put them up. (Be careful with decoration choices. Blinking lights may confuse or scare a person with dementia, and decorations that look like food could be mistaken as edible.)
  • Maintain a normal routine.
    Sticking to the person’s normal routine will help keep the holidays from becoming disruptive or confusing. Plan time for breaks and rest.

Adapt gift giving

  • Encourage safe and useful gifts for the person with dementia.
    Diminishing capacity may make some gifts unusable or even dangerous to a person with dementia. If someone asks for gift ideas, suggest items the person with dementia needs or can easily enjoy. Ideas include: an identification bracelet (available through MedicAlert® + Alzheimer’s Association Safe Return®), comfortable clothing, audiotapes of favorite music, videos and photo albums.
  • Put respite care on your wish list.
    If friends or family ask what you want for a gift, suggest a gift certificate or something that will help you take care of yourself as you care for your loved one. This could be a cleaning or household chore service, an offer to provide respite care, or something that provides you with a bit of rest and relaxation.

Reduce post-holiday stress

  • Arrange for respite care so you can enjoy a movie or lunch with a friend.

When the person lives in a care facility

A holiday is still a holiday whether it is celebrated at home or at a care facility. Here are some ways to celebrate together:

  • Consider joining your loved one in any facility-planned holiday activities
  • Bring a favorite holiday food to share
  • Sing holiday songs and ask if other residents can join in
  • Read a favorite holiday story or poem out loud
To read more from the Alzheimer’s Association, click here. For more information on elder law, please visit www.elderlawnewyork.com.

Preparing for Crisis and Disaster from an Attorney’s Perspective

Tuesday, November 6th, 2012

By Scott M. Solkoff, Esq.[1]

People with dementia thrive on routine.  When the normal calendar of life is disrupted by crisis or disaster, it can be upsetting to any person – but for a person with dementia, it can be a very real threat.  From my view as an Elder Law Attorney, having worked with thousands of families to plan for their future, I have learned some simple steps that can be taken now to prevent big problems later.

Crisis and disaster can strike in many ways.  In Florida, it can come ashore as a hurricane but can also be caused by a health event, the sudden loss of a caregiver, fire and other causes that could befall any of us.  What all of these events have in common is a major disruption in routine and an increased need for safety and communication.  Most people know to keep flashlights, batteries, a water reserve, canned food, a manual can opener and other such supplies on hand.  This should be done and a caregiver should make a list and check the home regularly.  If the subject of our concerns is in a facility, the caregiver should speak with facility personnel about provisions.  Each facility is mandated by law to have a disaster plan and the caregiver should be aware of that plan.  For example, if a facility has no power, is there a generator large enough to meet basic needs?  Where would your loved one be taken if the facility itself becomes unsafe?  Get the answers.

Access and communication is critical.  You must be able to establish your authority to act for your loved one.  As a caregiver, you should have copies, if not originals, of all important legal documents, most important among them being the durable power of attorney, any trust agreements and the health care surrogate designation.  If at all feasible, the elder should also have copies, even if suffering from significant dementia, of the health care documents.  My clients are supplied with “digital pocket vaults,” flash drives that we have fabricated to be about the size of a credit card and which are kept right behind the person’s drivers’ license.  If I have an incident and paramedics come, they must look in my wallet for my I.D.  Right behind my I.D., is this special “vault.”  As soon as it is plugged into any computer (e.g., in the ambulance or the hospital), my caregiver’s name and phone number pop up so that they can be quickly identified and contacted.  My health care surrogate designation and living will are also on the card.  Create some way to make these critical documents portable.  Put a noticeable sticker on the refrigerator (another place paramedics often look) with caregiver contact information.  You can even put a sticker on the outside of the fridge telling the paramedics to look in the refrigerator door for a copy of the health care documents, a common practice.  Some organizations provide “safe return” bracelets, a wonderful tool that allows anyone who finds your loved one to get him or her back to safety.

One of the most important safety devices is people.  Make sure you, as a caregiver, have people you can count on to do the simple task of knocking on your loved one’s door if you cannot reach them yourself.  Get to know at least one neighbor.  Call your loved one regularly to “check in.”  If there is no answer, do not panic.  There is more often than not a good reason.  If there is still no answer and too much time has passed, call that neighbor to go knock on the door.

To read more about elder law and estate planning, please visit www.elderlawnewyork.com.  Two of the nation’s leading elder law and special needs planning firms, one in Florida and one in New York, have developed a relationship to coordinate services and knowledge for people who have connections to both states. Solkoff Legal, P.A., of Delray Beach, Florida and Littman Krooks, LLP of Manhattan, White Plains, and Fishkill, New York are dedicated to helping seniors and individuals with special needs, along with their caregivers and their families, to read more, click here.


[1] Scott Solkoff is a Florida Bar board certified Elder Law attorney, co-author (with his father) of West Publisher’s national and state books on Elder Law, Past-Chair of the Elder Law Section of The Florida Bar and a Fellow of the American College of Trusts and Estate Counsel (ACTEC).  Scott practices Elder and Disability Law in Delray Beach, Florida.