Don't Let Senile Dementia Catch You Unprepared

Suddenly we have an increasing number of calls by people about loved ones in the beginning stages of dementia or Alzheimer’s.  Because of their condition, we find our new clients:

  • Very lucid and intelligent and easily offended if treated otherwise
  • Are able to handle money and the use of credit cards with an outward appearance of normalcy
  • Handle paperwork just sufficiently to appear in control
  • Think they are in control when often they are not
  • Will lose track of time or the day of the week and, as a result, appointments are missed
  • May, uncharacteristically, run up credit card debts or miss bill payments
  • Are unable to handle unsolicited calls well
  • When faced with an answering machine, they don’t leave coherent messages
  • Don’t recognize the need for help
  • Are often in and out of reality
  • May occasionally get lost

How do we honor the intelligence they once had, and still have, while relieving them of the responsibilities which they are neglecting? Working from the financial side, we experience how complicated the situation is.

Don't Let Senile Dementia Catch You Unprepared - Clients' Stories

Maria was in the midst of adjusting to having a legal guardian handling her financial affairs.  An attorney who has guardianship for Maria requested that Rebecca meet with his client once a week to collect mail, research whether she has a current will, help her cash a check for weekly expenses, as well as learn about the client’s living family members and find their contact information.  Maria is charming and chatty and has very clear, well explained, reasons why she should be handling her money herself. None-the-less, she calls Rebecca several times a day to find out when they are going to the bank to get cash.

Joyce has had her neighbors worried about her safety and health for a few months now.  She teaches English part time, enjoys walking to concerts in the neighborhood and getting together with friends.  Recently she forgot to teach her class, left for her Thanksgiving weekend with her sister a few days too soon, was slurring her speech, and began to allow mail to accumulate in her apartment.  Joyce is probably too high functioning to be in the neighborhood’s assisted living facility for Alzheimer clients.  She needs twice daily medication reminders, but probably is not ready to have a home health aide.  We seem to have found a solution through a Home Health Aide agency which can supervise her medications and make phone calls to remind her.

Lydia has been retired for twenty years.  She was a writer for an ad agency for her career.  Based on one conversation, Rebecca was able to glean from Lydia that after retirement she filled her days easily.  She had meals with friends, conversing about books and movies, went bicycle riding, enjoyed the company of her dog and dabbled in painting. From the many issues of The New Yorker lying around the apartment and the wide variety of books, it is clear she loved to read as well  Lydia was discharged in the care of a home health aide from a nursing home where she had been for rehab.  Rebecca was brought in to help her deal with her finances.  At first the tasks at hand appeared to be the normal consequence of Lydia having had a series of medical problems which kept her from paying her bills or submitting her tax returns.  However, the physical therapist who has worked with Lydia after two discharges from the nursing home is convinced that the problem is dementia.  The home health aide reports that there is disorientation in the evenings and forgetfulness during the day. Rebecca has also had to deal with Lydia’s forgetfulness.  At first Lydia said she had no will, Health Care Proxy, or Power of Attorney, but the attorney Rebecca hired for Lydia was able to ascertain, through conversation with Lydia, that she does have a will and where it is located.  On another day, when told that the IRS was sending letters saying she had not submitted tax returns, Lydia understood that there was a problem, but she could not tell Rebecca if she had an accountant who could be contacted.

When Senile Dementia Catches You Unprepared – Some Suggestions

When family members discover that their loved ones have changed since the last get together there tends to be panic about what to do.  The fine line between competency and incompetency creates a delicate situation for those trying to help.  It can be very difficult to handle the situation without assistance. As mentioned in previous newsletters, we encourage the building of a team so that medical, legal and financial plans can be created.  This way loved ones can be helped to function better now (or at least stabilize) and to be prepared for any mental or physical deterioration in the future.  The goal is to have everything in place while a loved one is still competent enough to understand the decisions that are being made and to get used to the newly created routines.  Everyone needs to have a Health Care Proxy and a Power of Attorney to prepare for the unexpected.  However, if we find that a loved one is losing mental capacity, there is greater urgency to have the documents prepared while the loved one is still capable of making the needed decisions.  If the necessary documents are not in place when it becomes apparent that a loved one can no longer handle his/her own affairs, then guardianship proceedings may be required.  It is easy to ignore signs that a family member is not “all there”, or to think that there has been a temporary setback.  The inclination may be to keep the peace, to not pry into personal affairs. None-the-less, uncomfortable planning needs to take place now in order to make the future as comfortable as possible.

January 2009 - FEATURE
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