June/July 2013 Print - Debra Levy Eldercare Associates

Vacation without Mom

Sometimes the best way to care for your loved one is to take an extended break and recharge your batteries. Plan well in advance for care. Options to consider:

Family members. Whenever possible, ask siblings several months to a year ahead of time. They may need the notice to make arrangements at work. If they live out of town, have them come early so you can orient them to the routines. This is especially important if your relative has memory problems. Familiar routines will help keep your loved one calm.
Agencies. Allow yourself at least three months’ lead-time if you need to hire in-home care. Use the agency for a trial period as training before you go.
Facilities. Similarly, if you need to find a facility for short-term residential care, start looking 3 months ahead. Consider taking your relative to the facility for lunch several times before you leave. Your loved one will come to feel more comfortable. Plus, the staff and administration will think of you first as they strive to match short-term requests with upcoming vacancies.
Geriatric care managers. Ask about “vacation packages.” A geriatric care manager can find and hire care and can provide ongoing supervision while you’re away.

If your relative does not need assistance with personal care, consider these other services that may be helpful:

a daily check-in call from a friend, nearby relative, or a phone visiting service;
a medical alert system (a single-button pendant for summoning emergency help);
temporary “meals-on-wheels.”

Also ensure that all bills are up to date or prepaid and that adequate supplies of medications are on hand.

In case of emergency, leave complete information about your relative’s medical insurance, health history, current prescriptions, and doctor and pharmacist contacts. Include a completed advance care directive and instructions about how to reach you.

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What is mild cognitive impairment?

“Senior moments” are a normal part of aging. They happen to everyone. We just don’t process things as quickly as we did in younger years.

Some people develop significant memory and thinking problems, however, and are eventually unable to live safely on their own. These people have conditions that bring on a full-fledged dementia, such as Alzheimer’s or Parkinson’s disease.

And some people function at a level in between. They can live independently and lead normal lives. But they just aren’t thinking as well as they used to. These people may have mild cognitive impairment (MCI).

Signs of MCI include greater than usual difficulty with

remembering recent events or scheduled appointments,
following the thread of a conversation or movie,
making decisions or following instructions,
finding familiar locations, or
making well-reasoned choices.

About half the people diagnosed with MCI go on to develop Alzheimer’s disease or some other form of dementia, typically within five years. Others simply stay at this mild level of memory loss. Some even improve over time!

If you think your loved one may have MCI, schedule an appointment for a full medical exam. It may be MCI, or it could be as simple as a medication side effect or even sleep apnea or alcohol overuse. Follow up every six months to track changes.

If your relative has MCI, there is no treatment, per se. There are, however, things she or he can do to stack the deck in favor of good brain function:

Increase physical activity. Exercise helps keep the heart and circulatory system strong, which is essential to brain health.
Increase social and mental activity. People who are socially engaged or who have a hobby tend to keep their mental functions longer. Passive activities, such as watching TV, aren’t as helpful.
Manage blood pressure. Not too high (risks for stroke). Not too low (results in foggy thinking).

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When your relative has money questions

Is Dad asking if he should sell the house now that Mom is gone? Or perhaps Aunt Mary is anxious about her savings running out. Even if you are good at managing your own money, helping a relative make financial decisions can bring a lot of pressure. Consider hiring a professional advisor.

Ask your friends for the names of financial services specialists (financial planners or investment advisors) they would recommend.

Interview several candidates, in person. Ask about

experience and education. How long have they been in the advising business? (Aim for at least three years.) What kind of training did they receive?
typical client. What kinds of clients do they work with routinely? You are looking for someone who specializes in elders.
payment. Are they paid an hourly fee for services? Or do they get a commission based on selling investments to you? Or perhaps a fee based on how much money they manage for you?
certification and regulatory oversight. Ask about their certification and what agency secures the firm’s work. For the latter, you want to hear one of three answers: the Financial Industry Regulatory Authority (FINRA), the Securities and Exchange Commission (SEC), or the state securities agency. Visit the securing agency’s website to check for complaints about the advisor or firm.

Ask yourself how comfortable you are with the person. Does he or she explain concepts patiently and in terms you can understand? The last thing you want is someone who snows you with jargon and numbers.

Finally, consider having an elder law attorney check any recommendations. There may be tax implications. In addition, decisions made now could unknowingly affect eligibility for Medicaid and other long-term care options.

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