There are creative and effective ways to help an aging parent, family member or loved one who suffers from Alzheimer’s disease or dementia cope with the loss of their spouse, according to a new survey of aging experts released this week by the National Association of Professional Geriatric Care Managers (NAPGCM).
Remembering that there are different stages and types of dementia, making sure the surviving spouse does not become socially isolated and not rushing other major changes in their lives are among the top expert recommendations.
Americans are increasingly challenged by the need to communicate difficult information to aging family members with dementia. According to the National Institutes of Health as many as 5 million of the 43 million Americans age 65 and older may have Alzheimer’s disease and another 1.8 million people have some other form of dementia. And, according to the the number of Americans with Alzheimer’s disease and other dementias will escalate rapidly in coming years as baby boomers age. By 2050, the number of people age 65 and older with Alzheimer’s disease may nearly triple, from 5 million to as many as 16 million, barring the development of medical breakthroughs to prevent, slow or stop the disease.
June is Alzheimer’s and Brain Awareness Month. NAPGCM is releasing the results of its latest survey to help American families facing one of the most difficult of these challenges. NAPGCM polled 288 professional geriatric care managers in Los Angeles, CA and across the country asking them to identify the most effective strategies for helping a loved one with dementia cope with the loss of their spouse. The top six strategies identified by the aging experts are:
1. Remember there are many different stages of dementia. Your loved one’s capacity for understanding, coping and grieving can be very different depending on their stage of dementia. (Identified by 96% of survey respondents)
2. If your loved one’s response to reminiscing about their spouse is positive, share old photos and memories. (88 %)
3. Make sure the surviving spouse is not socially isolated. Schedule visitors on a regular basis and help them keep up with any normal social routines they have. (85%)
4. Reassure them there are people who care about them and will care for them. (84%)
5. Don’t rush big changes. It may make sense for them at some point to move to a facility, or closer to family. But, if possible, give them time to adapt so there aren’t too many major life changes at once. (81%)
6. If they choose to be included in mourning rituals for their spouse, make sure there is someone overseeing this so if the situation becomes too stressful they can leave. (78%)
“With the rising rates of Alzheimer’s disease and dementia in our community, we often see families who face such challenging situations,” said Trina Duke, Gerontologist and Care Manager, Los Angeles, CA. “Our survey findings offer some sound expert advice for families.”
The Alzheimer’s Association is a leading resource for families seeking information on the diagnosis, treatment, and stages of the disease. Their website provides information on living with Alzheimer’s and other dementias, tips for caregivers, and financial and legal planning. Go to www.alz.org. Help is only a phone call away on their 24/7 Helpline at 1-800-272-3900.
Local chapters provide educational programs, community support groups, and creative workshops for persons with dementia and their caregivers. The Alzheimer’s Association California Southland Chapter assists people with Alzheimer’s and their families and educates the public about Alzheimer’s disease. The chapter offers a variety of diverse programs and services. It serves the diverse counties of Los Angeles, Riverside, San Bernardino, Inyo, Kings, Mono and Tulare.
Raya’s Paradise Residential Care Communities Blog
Come read Raya’s Paradise blog about assisted living Los Angeles.
“We’re so lucky.”
I kept saying that to my sisters following my 90-year-old father’s passing in early 2013. I’m not sure they appreciated why I kept saying that. I said it because we were lucky he’d lived a great life. We were lucky to have had him so long, especially given my mother had died in 1988. We were lucky Dad had all his faculties to the end, even as his body disintegrated.
Most of all, though, we were lucky he’d generated and executed a complete estate plan. Thanks to John Heebner’s sense of responsibility, the logistics, legalities and, above all, the grief of his daughters weren’t multiplied needlessly by a lack of foresight on the part of our parent.
I knew where he kept the documents. He’d made sure to show me which file drawer they were in a few years prior to his death. He’d put together a trust to avoid probate. He’d also made it clear, as my mother had many years before, that he did not want extensive measures used to prolong his life. He had his Power of Attorney ready to go. He’d made his attorney the executor of his will so we girls wouldn’t argue over it. (Yes, we would have.)
A friend of mine who’s an excellent Geriatric Care Manager knew a successful doctor who, in his mid-80s, had all his estate planning and paperwork done. It was found in his desk drawer following his death – all unsigned. His estate wound up in probate, of course, and the difficulty and pain were compounded because there had been two marriages, two sets of offspring – but nothing had been updated since the first marriage.
My own estate planning attorney now has to struggle with the fact that there are now only two – count ‘em, two! – probate courts for the whole of Los Angeles County. When he needs to go to trial on behalf of a client, it’s now often an eight to ten month wait for a court date. Talk about prolonging the agony.
My Dad had even cleared much of the superfluous stuff out of the house, something I often do on behalf of other families as a Senior Move Manager. But Dad had taken the time to do a lot of the decluttering so his daughters wouldn’t have to, although there was one thing John Heebner did hoard. Given that my father had been a very successful businessman in Buffalo and that he had an MBA from Harvard, I don’t suppose it’s really so great a surprise that he’d kept all his tax returns back to 1957.
Given all he’d done for us, I couldn’t really begrudge him his collection of 1040s, even as I was lugging 256 pounds worth of them out of the house for shredding. After all, he’d made sure all the vital paper, all the documents we’d really need, were there waiting for us.
If you don’t plan for a grand finale, you – and your family – can easily wind up with a tragic ending.
Marty Stevens-Heebner
Happy Earth Day!!!
This afternoon the residents and staff of Raya’s Paradise Board & Care facility at 849 Gardner in West Hollywood will be celebrating Earth Day with the Hollywood Boys and Girls Club.
The kids will be sharing fun stories and treats with the residents. Each of the kids will be taking home a plant from our herb garden to take to their own home to start their own sustainable herb garden.
Be sure to check out all of the fun photo’s on our Facebook page at www.facebook.com/rayasparadise!!!
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Let’s say that your mother has granted you power of attorney over her finances, and she has recently become unable to manage her own affairs due to dementia. Upon looking into her accounts, you discover that she has several thousand dollars worth of debt. Can the creditors come after you personally for this money?
No, they cannot. This holds true even if you have power of attorney. The only way you can be responsible for your parent’s debt is if you were also a co-signer on the loan. But, those of us who feel duty-bound to do the right thing may want to make sure that the bill gets paid anyway. Here are some things to consider before you proceed.
What type of debt does your loved one have? Depending on who the creditor is and the conditions of the loan, the rules for paying back the debt or your sense of obligation might be different. A bank loan is going to be relatively impersonal. The bank will be business-like if there’s a problem with the account, and if everything’s in order will probably not hassle you to repay the whole loan quickly. However, if your mother owes money to a contractor who also happens to be a family friend, and he needs the money, the debt will be much harder to ignore.
Is there a way to contest or renegotiate the debt? For example, was your mother taken advantage of by an unethical salesperson? Did she put a doctor’s bill on a credit card rather than working out a payment plan directly with the office? Can items be returned or recurring services canceled?
Explore different ways of addressing the problem. It’s always worth calling the creditors to see if more favorable arrangements can be negotiated, and the Consumer Credit Counseling Service can help you with working things out fairly. Also, examine your parent’s finances carefully to determine if a source of funding is available. For example, they may qualify for a reverse mortgage that can help you get the debt taken care of quickly. And if your parent has passed away, the matter is as simple as using whatever funds remain in the estate to pay what you can, and then notifiying whoever has not been paid that there are no more assets.
If there’s no money available to pay the creditor and your parent is still alive, you can simply try asking them to forgive the debt (though they may not buy that there are no assets unless your parent is on Medicaid). Your parent can also declare bankruptcy. You’ll of course want to speak with a lawyer before considering this step.
Few of us are comfortable leaving debts unpaid, but if you follow the steps above you will have done your due diligence to get creditors what they are owed.
Most people have fond memories of at least one of their grandparents. These are some of our most cherished relationships. It’s important to both your children and your parents that they make the most of this relationship while they still can. During this difficult time when the family struggles with dementia or the poor health of your parent, strong grandparent-grandchild relationships are vital and can be very nurturing to them both. Often people leave children out during times of illness, but if this happens they can miss out on the chance to help a relative who needs them.
As adults, we want to feel that we are valuable and that we’re making a contribution to our world. That’s what makes old age so tough – we can begin to feel that we’re no longer relevant and that we no longer matter. Kids, on the other hand, want to be recognized for what they do well, especially when they’re teenagers.
Kids today often don’t know much about history, and this is where a good relationship with their grandparents can really benefit them. They have much to learn about where they come from, and about things that happened before they were born. Even if your parent thinks your family history is unremarkable, your kids are likely to be curious and glad to know where they came from.
And kids, in turn, know quite a few things that grandparents don’t. They may be able to set up your mom’s new DVD player faster than you can say “Gone with the Wind” or they are pros at doing that cool new dance everyone’s talking about. Even a sullen teenager may be more receptive to assisted living visits if you find some way to incorporate their talents. Maybe they can build an online photo album with treasured images to share with their grandparent. Or, if they were just in a school play, maybe your child and their classmates will agree to volunteer to perform a few scenes to entertain the assisted living residents. (Won’t mom be proud!)
Make sure that both grandchild and grandparent know what they can contribute to the other, and ask each of them privately to help you by contributing their knowledge and spending time together.
By each of them sharing what they know and what they’re good at, grandparents and grandchildren can meet each other’s emotional needs. So getting them to spend time together can be good for your parent, good for your kids, and ultimately, good for you because everyone’s happier and a little less stressed.
When thinking about how to pay for assisted living, one option that seniors and their caregivers forget about is the ability to turn any active life insurance policy into a long-term care benefit plan. This little-known option has actually been in existence for decades, but few people take advantage of it.
Once a person reaches old age, life insurance is nice to have but not crucial, as more often than not they don’t have any dependents. However, long-term care is a major expense at this point in time. This option gives seniors the flexibility to use this investment for needs that are more pressing. The benefit can be used with any type of life insurance policy: term, whole, or universal.
In some ways, this benefit is similar to regular long-term care insurance (though the two are not exactly the same). Once the life insurance policy is converted, ownership of the policy shifts from the policyholder to a benefits administrator entity. The benefits administrator takes over responsibility for paying the monthly premiums on the policy. An account is set up from which the benefits administrator pays a specific amount, based on the value of the policy, towards the original policyholder’s long-term care needs. Often the monthly payment is flexible – for example, if the value of your policy is $24,000, you might be able to choose to receive $2,000 per month for 12 months, or $1,000 per month for 24 months.
It may not be a large enough amount to pay the full assisted living bill, but it can yield a significant monthly sum that will go a long way towards defraying costs. In many cases, the long-term care benefit is worth much more than the cash the policyholder would get by simply surrendering the policy.
Taking this option doesn’t mean completely forgoing the benefits of life insurance. You are often able to keep a small funeral benefit worth around one or two thousand dollars.
There are several reasons why this route may NOT work for you. For example, if you have a small policy of $10,000 or less, you’ll likely find that it’s better to choose the cash surrender value or simply keep the life insurance. Also, in some cases the cash surrender value may be larger than the long-term care benefit. Finally, in order to use this option you must have an immediate need for some form of approved long-term care. Payments are made directly to the long-term care provider, not to you.
If this seems like a possible option for you or your loved one, speak with a financial advisor who specializes in helping seniors.
When it comes time for a senior to move into assisted living, one of the most important items on the to-do list is to sell the person’s home. Often, the money from the sale is needed to pay for necessary care. It has to be done, but there’s a catch: only a homeowner can legally sell their home. If Alzheimer’s has already incapacitated the person, then getting this task done becomes difficult.
Basically, you cannot act if you do not have power of attorney. Hopefully, your parent was organized enough to assign this power to a family member or other trusted person while they still had the capability to make these important decisions. But all too often, this step has been postponed, and now that the parent has lost capacity to make decisions, it’s too late. The caregiver’s only option now is to apply for guardianship of their loved one through the legal system.
However, be forewarned that the process of obtaining guardianship is expensive and draining. For one thing, the court will need to award you the right to complete every step of the process. You need to have permission to sell the home, you need to get court approval of the sale price, and then you need to have permission to use the proceeds to pay for senior care. Getting these rulings made will take anywhere from a few weeks to a couple months, which seems to be a long time to wait when the money is needed now.
The first step is to find a buyer who’s interested in the house, and then get them to sign a contract. The contract must state that the sale is conditional upon court approval. You can then file this document with the court and wait for them to review it and approve the terms of the sale. Unfortunately, it’s not uncommon for buyers to decide that this extra step is too much trouble. If they can find a house they like just as much without restrictions like this, they may decide to walk away from the deal.
The process isn’t necessarily any easier even if the caregiver has power of attorney. Sometimes the title company puts up obstacles and challenges the validity of the agreement between the senior and the caregiver. They may want your parent to still sign something to approve the sale, or they may want to meet with them to confirm that they are incapacitated.
In the end, the takeaway message is that selling a parent’s home is complicated, and you should be prepared for a lengthy and challenging process. Your best course of action is to find a lawyer specializing in elder law, who will be able to guide you through the process in the most painless way possible.
When someone has received a terminal diagnosis, it’s a sensitive and traumatic time for them. Our words and actions at this point carry great weight. While it would be nice to believe that there’s no wrong thing to say and it’s the thought that counts, those close to the dying can make the experience easier or harder for them depending on what they say.
If your loved one has recently received the bad news, look to them for clues about what to say and do. Don’t be surprised if they in fact don’t want to talk at all. People facing their own passing are often relieved to not have others say anything – though they are also glad to know that they can reach out if they choose to do so. Do your best to respect what they want, but find ways to make it clear that you’re willing to offer a listening ear when they need it. Rather than fretting about what to say and whether it’s the “right thing,” put your energy into listening to and observing your loved one.
Whatever you do, avoid grand platitudes about fate or God’s will. These won’t make the person feel better, and may even make them feel that they are at fault for their illness in some way. Don’t tell your loved one that they’ll be OK – both you and they know that this isn’t really true. Don’t try to praise them by telling them how strong they are – at this time they may not feel very strong. Instead, they need to be allowed to acknowledge their fears.
Find ways to emphasize that you love them and that you’re there to help them in the way they need. Do your best to make this time pleasant and comfortable for them. This is one exception to the advice to let your loved one guide you – as far as comfort goes you should take the lead. This is the time for random acts of kindness like making them breakfast or doing their laundry for them. They may be too preoccupied to ask for help with these everyday tasks. Make sure that you follow through on any offers you make.
What gift do you give someone who doesn’t have many days left in the physical world? The gift of your time. Even sitting quietly with your loved one can be valuable to them. It sends the message that you’re there for them and that you’re willing to support them in their struggles.
Many of us are doing more and more online shopping, and so inevitably we wonder if we should buy medication online too. Beyond the simple convenience, the cost savings are certainly tempting, especially when dealing with an expensive chronic condition. However, the world of online prescription drugs is one that needs to be navigated with caution. Counterfeit medicine is abundant, and the old saying that “if it seems too good to be true, it probably is” was never more apt.
There are both legitimate and illegitimate online pharmacies, and the trick to buying medicine online successfully is to be able to tell the difference. By taking the time to gain a little knowledge, you too can be an informed consumer and avoid getting burned.
Here are signs of a reputable and safe online pharmacy:
- They require that you submit a prescription from your doctor. Usually they will ask for this by mail. If they allow you to send a fax or a scanned copy, they should then check with your doctor to make sure that the prescription is legitimate. Avoid sites that will send you medicine just on the basis of a questionnaire, without requiring you to visit your doctor.
- They should also require that you fill out a detailed profile that includes your medical history.
- You should be able to speak to a licensed pharmacist who can answer any questions you might have.
- The pharmacy should be located in the United States. Many online pharmcies are located abroad. The prices may be cheap, but as much as 40% of the medicine in these countries is counterfeit, so you’re much more likely to not get what you paid for, or even something that’s safe to consume.
- You can easily find and understand the website’s various policies regarding privacy, shipping, and payment.