Independence in Dementia: Family Decisions

by Clarice Cagle Cook, CDP April 4, 2017

An older woman is losing her short term memory and cognition.  One daughter is insisting that the older brother, who is the Power of Attorney, sell her home, and set mom up in a nearby nursing facility.

The older brother talks with mother about it and the answer is this:  “When I burn the house down, you can take it all.  Until then, hold your horses.  I’m not going anywhere yet.”

The older brother is taken aback for a moment, but then decides that Mom has always been independent and straightforward.  The sister, who is in the room and hears this response is upset.  “That’s it.  We can’t wait until you hurt yourself before we do something, Mother.  You’re always falling and forgetting things.  What if you take the wrong medication or heaven forbid actually burn the house down?”

Mother turns to her daughter.   “Kathy Marie, all you care about is inheriting the property.  If you put me into the nursing home, they’ll take everything I own to pay for it, because you know I don’t have a lot of money. Besides, you’d have to have me declared incompetent and that’s not going to happen.”

The older brother, Dan says, “Well this meeting is over. Kathy, don’t you have to get back to work?  I know that I do.”

Outside the house, Kathy brings the subject up again.  “Dan, I’m afraid of what’s going to happen to Mom. She has a care alert button, but half the time she forgets to wear it and you know the last time she fell, she lay there for who knows how long trying to get up without pushing the button.  If I hadn’t come in when I did, who knows what would have happened.  What if she’d had something on the stove and couldn’t get to it?”

“I know sis.  I’m going to check in home care options.  It’s too early to consider putting her into a facility.”

“The expense would eat up her savings and her house.   And who can we trust to come into her house.  She’s not going to accept that. That won’t work.”

This scenario is an example of the struggles that families go through every day in deciding what to do about their parents when they start showing signs of decline.

The first order of business is to sit down with the parent in conversation and let them know that you are going to be a partner, and go to the doctor appointments with them.  If necessary, the Power of Attorney might have to request a consultation with the doctor alone.  But the ideal solution is to be able to keep the parent a major part of the discussion.

The parent needs to have a complete physical check up every year, but if memory or cognitive symptoms show up, the doctor needs to rule out any physical causes before running test for dementia. Any dementia tests need to be overseen by an accredited dementia care trained doctor and the tests need to include more extensive trials than just the simple memory (three words) test.

Nursing Home versus In Home

A wise doctor told me once when the family was looking for a facility for a family member…”Pick the best of the evils.”  Sounds simple…but not so.  Checking for a nursing home that can give quality care is a daunting chore.  You will most likely never find one that can insure quality of life.

In the first place, quality of life is a totally different issue for every individual.  Putting someone at that stage of life into a strange environment with different schedules and with sharing of common space is upsetting for the highest functioning people.

In looking for in home caregivers, find an agency that can provide you with copies of background checks and ask to interview those persons who will be in the home. Security cameras are also a safety method. Find an agency that will comply and be partners.

There is never a perfect answer.  However, the outcome and assurance of quality of life for the entire family is higher if everyone cooperates and comes together as a team.

Read, read, read and use your very best instincts in working with that parent.  The key word is working with.  Go to sites like Alz.org, and dementia.org for answers.

Creating the Dynamic Dementia Care Team and Memory Path Care Solutions are two manuals dedicated to families and caregivers of persons with dementia.  Both manuals are available in print at Amazon.com and Barnes and Nobel.com.  Audio versions narrated by Leigh Ashman and Donna Motta are available at Amazon.com and Audible.com.  For free downloads of either or both audio books, contact Clarice Cagle Cook at creatorwriting@outlook.com  Enter “Audio Download Code Request” in the subject line.

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