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Alzheimer’s Caregivers’ Advice | Illinois Estate Planning & Eldercare Attorney-CPA Anthony B. Ferraro

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January 8, 2014

- Alzheimer's Care, Eldercare Attorney, Estate Planning Attorney

Assuming the role of a caregiver for a loved one with Alzheimer’s is very hard. It can be a struggle, both physically and mentally.  As an Alzheimer’s caregiver, you are going to be approaching challenges that are both new and frightening. Alzheimer’s is a complex disease and it can affect your loved one in many different ways.  Someone with Alzheimer’s may struggle doing simple tasks such as getting dressed or eating.  The typical Alzheimer’s patient will also face confusion and, therefore, you will receive repetitive questions and see odd behavior. In a situation like this, it is normal to feel trapped.  However, I am here to assure you that there are ways to make you and your loved one’s journey through Alzheimer’s easier. First off, I suggest that you abferrarolaw.com/senior-resource-kits/alzheimers-resource-kit/.  There you will find many tools on how to cope through the Alzheimer’s journey, including the recording called, “Caring for and Communicating with the Alzheimer’s Patient.” Other helpful information covered on the above website includes paying for the cost of Alzheimer’s care, discovering hidden VA benefits, and how to approach crucial legal documents. -Anthony B. Ferraro
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How can we encourage a more collaborative spirit, rather than “them vs. us,” when it comes to my mother’s nursing home staff? ? | Chicago Long-Term Care Planning Attorney Anthony B. Ferraro

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August 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

First of all, for family members: When you first admit a loved one to a nursing home, you should get to know the staff. Let them know that you care about their well being (in addition to your loved one’s) and that you would like an open relationship so you all can discuss issues concerning your mother’s care. Inform them about pertinent information concerning her and her life — what she likes, dislikes, any habits she might have, typical moods, and what seems to work when approach her in different situations. The more her caregivers know, the better they can care for her. Compliment staff members when you learn about them doing something you like. Be involved at the facility as much as possible. Attend social events and family council meetings if you can. One good example of relationships being built very well involves a man who took a picture of his wife and the staff on her unit. He had an 8-by-10-inch shot of it made and wrote the name of each caregiver underneath it. When placed on his wife’s closet door, it served as an aid to helping her recognize the people taking care of her. It also made the staff members feel very included. It made them feel important and let them know that the family really cared about them. This gesture built a lot of good will and enhanced his wife’s care. To the staff: Don’t be intimidated by residents and/or their families. You are the frontline worker, an honorable position. Without you, there would be no care for their loved one. That is a compliment of the highest order. Show interest not only in the resident, but also his or her family. Introduce yourself and tell them a little bit about your background, your interests, how long you have been a caregiver and why you are in that line of work. When family members enter the unit, greet them cheerfully and give them information about their loved one, whether the news is good, bad or indifferent. What many caregivers don’t think to do is call a resident’s family if something good happens during the day. These are blessings that can be few and far between for family members, and they’ll go a long way. Unfortunately, there can be stigmas about nursing homes and their caregivers. For the most part, these workers are intent on doing a good job and truly care about what they do and who is in their charge. Everyone needs to work together to overcome negative stereotypes so residents will have positive experiences in their new home.
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My father keeps asking to go home. What do we tell him? ? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

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August 20, 2012

- Alzheimer's Care, Blog, Elder Law Articles

When your father or any loved one starts to ask about home, someone could drive them past a previous home, even from childhood. Often, he will not recognize the old house because a house and a home are two different things. That’s why it is best to make him feel safe and secure, regardless of wherever he is. To most people, “home” is a place where we feel loved and accepted — and safe. So the best way to answer your question is to think about the word “home” and what it signifies. Depending on where he is with memory loss, your father might be conjuring thoughts of a childhood home with his parents and siblings. Or the home where he was first married, the kids were young or any time before, after or in between He might be living in the same home he’s been in for 20 or 30 years and still ask to go home. Due to the nature of Alzheimer’s, your dad is likely feeling insecure, fearful, even unlovable. Please pay close attention to this next point: It is not your fault. He is dwindling a bit, day-by-day, and he is frightened. Fear can drive many emotions, not the least of which are insecurity, anxiety, anger and low self-esteem. Your father needs to feel safe. If he doesn’t carry good feelings about himself, he probably doesn’t feel he can be loved by anyone. Remember that the most important thing to realize is you need to constantly validate his feelings. Instead of telling him he is home, tell him simply that he is in a safe place and that he is loved very much. You can tell him, for example, “Dad, you’ll be staying with me and Anthony for a while. We’re happy you’re here and we love you.” Reminiscing about his childhood and looking back at his life and life accomplishments also should make him feel good about himself and decrease negative feelings. Because Alzheimer’s patients typically have short-term memory loss, he will nonetheless continue to ask about “home.” Repeat over and over that he is in a safe place and loved very much. Giving hugs throughout the day will truly say much more than words. A hug produces feelings of love, acceptance and security — three big concepts that continually need addressing.  For more information regarding how to treat a loved one with Alzheimer’s, click here.
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My father has late-stages Alzheimer’s and gets food pocketed in his throat, causing aspiration and food back-up. Does he need to get a feeding tube? | Chicago Elder Law Attorney Anthony B. Ferraro

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August 9, 2012

- Alzheimer's Care, Blog, Elder Law Articles

This can be a tricky subject. There is a lot of negative information circulated about feeding tubes, but they also can serve a legitimate, helpful purpose. First off, if your father has an advance directive, review its contents for guidance about his wishes regarding a feeding tube. Be sure to speak at length with his doctor about this issue. Sometimes other interventions are possible, such as speech therapy. Speech pathologists and therapists can introduce special swallowing techniques. However, the patient must be aware enough to understand instructions and carry them out. Discuss the different kinds of feeding tubes with your loved one’s doctor. There are numerous types and each should be explored. Some of them require more invasive procedures than others. Less invasive means less stress for your father. The doctor also should be able to explain the risks of using a feeding tube — and what the risks are if one isn’t used. Don’t hesitate to get a second opinion about feeding tubes. They are frequently an uncomfortable topic. Even if you have used a doctor for many years and trust him or her, it never hurts to get a second opinion. You need to be at peace when you make a decision about a feeding tube.
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How can you get a loved one with Alzheimer’s disease to eat more? | Chicago Long-Term Care Planning Attorney Anthony B. Ferraro

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August 8, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Often, as Alzheimer’s progresses, a person loses his or her appetite. Getting the person to eat can be a constant struggle. This is, in fact, one of the great challenges that Alzheimer’s caregivers face on a regular basis. It might be helpful to serve Alzheimer’s patients food on brightly colored plates and drinks in brightly colored cups or glasses. A study in a recent edition of Clinical Nutrition magazine revealed that when nursing home Alzheimer’s patients were served food on bright red plates, with red cutlery, they ate 24% more than when served on white plates. Similarly, bright red cups led to 84% more liquid being drunk than out of plain glasses. It’s a little-understood fact about Alzheimer’s that as the disease progresses, the ability to process all types of information is often lost. Outwardly it might seem obvious and easy for a person to recognize food on a plate, but it can be a challenge for an Alzheimer’s patient. So if other strategies for encouraging or cajoling more eating and drinking have failed, try serving food on bright red plates and putting beverages in red cups to encourage greater consumption.  To learn more, try the Alzheimer’s Resource Kit, click here.
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How will we know when it’s appropriate to move my dad from adult day care to a nursing home, or an assisted living facility? . | Chicago Long-Term Care Planning Attorney Anthony B. Ferraro

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July 26, 2012

- Alzheimer's Care, Blog, Elder Law Articles, Estate Planning, Medicaid and Paying for Nursing Home Care

The answer is simple: When you no longer can care for him at home. Adult day care is just a day service, so it occupies only part of the time. Care at home is still needed for nights and weekends. There are some adult care centers that offer evening and weekend services, but often it is not enough. Some people “package” services from a home care agency with the time spent at adult day care. In addition, a home care agency can assist with evening and weekend care to reduce the strain on you, and keep your father at home longer. But as you can see, that takes quite a bit of coordination, and still a fair amount of resources, to do properly. Everyone’s situation is different and everyone has a different threshold, so you have to figure out what is appropriate for you and your loved one. It is time to consider a nursing home or assisted living facility if you are feeling overwhelmed and the quality of life at home has fallen. You need to remember that it isn’t fair to either of you if your time with your father is so strained it diminishes your quality of life. If he were to go to an eldercare facility, your time together would likely be decreased, but then your time together could be that much more focused on doing things you like together, and in a lower stress environment. Some assisted living facilities have staff members who are trained and equipped to work with Alzheimer’s residents. But many do not. You must research any long-term care operator’s limitations before making a decision. Some will accept Alzheimer’s residents until they become incontinent or require some other type of skilled care. In that case, you must consider what an extra move might mean to your father’s well being and sense of orientation. This is a decision that you, as primary caregiver, must make. Everyone has different limitations and goals. When you know you have reached your limit, make the most appropriate, effective decision for everyone involved.  Realize you have done your best and that that is good enough. Let go of any guilt, for it can only destroy you.  For more information about Alzheimer`s, click here for our Resource Kit.  
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I’m scouting nursing homes for my mother, who has Alzheimer’s. Can they ever kick her out if she runs out of money? ? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

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July 25, 2012

- Alzheimer's Care, Blog, Elder Law Articles, Medicaid and Paying for Nursing Home Care

This is a good question that you need to sort out before making a final decision about specific living arrangements for your mother. Medicaid is for individuals who have little or no means to pay for their own care. Eldercare facilities must be certified by the appropriate government entities to serve Medicaid beneficiaries. Some nursing homes and other eldercare facilities simply are not certified to accept Medicaid funding once a resident runs out of his or her own money. And those facilities that do accept Medicaid could have a long waiting list for the beds designated for that type of care. That is why it is so important to figure out the lay of the land and your options before you initially settle your mother into a facility. Find out the monthly cost of a nursing home that interests you and project how much you think you will ultimately be needed. If you think your mother will outlast her funds, you can ensure you choose a provider that will accept Medicaid, when and if the need arises. Families of individuals with Alzheimer’s usually do not want to move their loved ones if they don’t have to, especially not after they have adjusted to their surroundings. Changing locations can be very stressful for a person with dementia.  To learn more about Medicaid, click here.
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How can I get a family council established at my husband’s nursing home? | Chicago Elder Law Attorney Anthony B. Ferraro

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July 20, 2012

- Alzheimer's Care, Blog, Elder Law Articles

When done right, family councils can be very beneficial. Their goal is to discuss issues with staff members in a constructive, non-threatening setting. They are not supposed to be forums for constant complaining or berating of staff. At these meetings, ideas, concerns and possible solutions are shared. It is also an opportunity for bonding with staff members. If you want to establish a council, speak with the nursing home’s administrator. These councils are common so you might not face much resistance. Establish a place, day and time to meet, as well as a format for how meetings will run and what will be addressed. You’ll also need to determine who will run such meetings, and create a way of informing all residents, family members and staff about them. The meetings can be informal, or quite formal — complete with minutes being taken. It’s up to everyone to decide. The structure isn’t as important as getting information out and distributed. One big function of family councils is to help arrange activities that involve both residents and their families. By this, we’re mainly talking about picnics held at the facility. These can help promote a sense of unity among residents, family members and staff.  For more information, look into our Alzheimer’s Resource Kit.  
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My father lives in a nursing home and we need to know how to deal with him constantly losing things such as his wallet, glasses, dentures, etc. | Chicago Long-Term Care Planning Attorney Anthony B. Ferraro

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July 19, 2012

- Alzheimer's Care, Blog, Elder Law Articles

First, talk to the person in charge of his unit and ask if there are any known reasons why these items are continually being lost. Then go from there. If your father is a hoarder or hides things on purpose, that is one issue; but if the items are disappearing “on their own,” that is another matter you might want to pursue with facility managers. If it comes down to the cost of replacing certain items, you might want to ask whether they are truly making a difference in your father’s life. Are they causing more strain or stress than the quality of life they bring? Replacing a wallet is probably easier to do than more expensive items. A wallet can give a person a sense of security. Therefore, purchasing a new, inexpensive wallet (or several, just to be prepared) can add to quality of life. Getting new glasses or dentures is quite different. If he still likes to read and needs his glasses to do so, then by all means replace them. Less expensive frames are widely available, and maybe inexpensive reading glasses (that can be bought at a local drug store) might be sufficient. Dentures obviously can play a big role in nutrition so they should be taken care of. Fixing them will be more economical than replacing them in most cases. Unfortunately, often a pattern emerges where once one set of dentures disappears, you know others also will get lost. Your father might be taking his dentures out due to discomfort. Also, if they are shifting in his mouth, he could develop sore gums, which could lead to a loss in weight. Check with a dentist for adjustments that can make your father’s dentures more comfortable.
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I think my mom’s medication is affecting her negatively. How can I get her nursing home to adjust it? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

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July 18, 2012

- Alzheimer's Care, Blog, Elder Law Articles

I recommend documenting what you have seen since your mother started the medication in question. You can also start out by directly calling the physician who prescribed it and asking about your concerns. Your mother could be experiencing a transition period, which might be expected. If you think you are getting resistance from nursing home staff members, you should speak with the facility’s administrator. You may also ask to sit in on the next care-planning meeting for your mother. This is where various members of the nursing home caregiving staff collectively discuss a resident’s health status and plan of care. By rule, you are to be informed of these meetings and allowed to attend them. If you are not satisfied with what you hear, then you have to make a further decision. There is the option of calling your state’s long-term care ombudsman. Ombudsmen have been trained to advocate on behalf of nursing home residents. This person can work as a mediator to help you and your mother’s facility work out any differences. You should feel comfortable enough that she is in a safe environment, with people who care for her around her. If this isn’t the case, you might have to move her to another nursing home. This is a difficult decision to come to because moving is hard, especially on a person with Alzheimer’s. Weigh the pros and cons. But the bottom line has to remain whether you are comfortable with the facility where your mother is living. If you’re constantly worried, then your qualify of life could go down. If all else fails in a situation like this and you are your mom’s power of attorney for healthcare, you can request a change in her medication. Just be sure to have spoken with her physician ahead of time to ensure that this is the best thing for her.  For more information, sign up for the Alzheimer’s Resource Kit here.
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