Should Your Loved One with Alzheimer’s Still be Driving? | Illinois Estate Planning & Eldercare Attorney-CPA Anthony B. Ferraro

January 14, 2014

One of the dilemmas a caregiver for someone with Alzheimer’s faces is whether or not they should continue to let their loved one drive. No longer allowing your loved one to drive can lead your loved one to a feeling of defeat and taking away their keys can mean the loss of your loved one’s independence; however, you must balance that loss with the safety of others on the road. An issue that many caregivers face surrounding the driving issue is their loved one’s insistence that there is no reason why they can no longer operate a vehicle. Even if you get the doctor to insist to the patient that they should no longer drive, due to the memory loss, the patient may completely forget what the doctor told them. So, you will find yourself in a seemingly never ending cycle of your loved one insisting on driving and you telling them no. In this case, the best thing to do is change the topic of conversation when the driving topic is brought up. Diverting to a lighter topic of conversation by saying something like, “What do you want for dinner tonight?” may feel odd at first, like you’re ignoring your loved one, but the truth is, switching to a lighter topic of conversation can be a great stress reliever for both you and your loved one, even if it is only for a brief moment. Changing to a lighter topic should not take away from the overall seriousness of the driving issue, but for the time being, it provides some relief and you both can move forward. It is important to realize that driving is one of the most challenging issues surrounding Alzheimer’s today. Helpful answers to this issue can come from the Alzheimer’s resource center at abferrarolaw.com/senior-resource-kits/alzheimers-resource-kit/. -Anthony B. Ferraro

Coping with Alzheimer’s | Chicago Estate Planning & Eldercare Attorney-CPA Anthony B. Ferraro

By Anthony Ferraro on

January 2, 2014

- Alzheimer's Care, Chicago Elder Law, Eldercare Attorney

Alzheimer’s has been termed “The Long Goodbye” due to its devastating effects that last for many years. When our loved ones have Alzheimer’s, it doesn’t only affects them, it affects us.

However, there is still hope: hope in learning how to cope with Alzheimer’s. As of today, there is no official cure for the disease, but by taking the simple steps many Alzheimer’s caregivers are using to cope, we can regain some peace of mind.

By visiting the website below, you will gain access to the Indispensable Alzheimer’s Resource Kit. This is a helpful tool that will assist you in providing stress-free care for both you and your loved one, as well as ways to pay for Alzheimer’s care without going broke.

abferrarolaw.com/senior-resource-kits/alzheimers-resource-kit/

I also encourage you to visit www.AlzheimersHope.com, which is an internet community that will give you the opportunity to connect with Alzheimer’s caregivers from around the world.

You are not alone in your journey through Alzheimer’s, and the above websites will assure you that there are many others experiencing the same thing as you.

If you have any other questions about Alzheimer’s or any other legal-related issues, please call my office at (847) 292-1220.

-Anthony B. Ferraro

Attorney-CPA

What can you explain about advance directives? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

By Anthony Ferraro on

August 28, 2012

- Blog, Elder Law Articles, Estate Planning

An advance directive is a form of direction that allows a person to express healthcare preferences in the case that person becomes unable to make or communicate his or her own decisions. Advance directives include a host of options, such as power of attorney for healthcare decisions, living wills and informal directives people make in letters, conversations and conduct. Any advance directive must be signed while a person still has approved mental capacity to sign legal documents. All people have a constitutional right to refuse any medical treatment, including ventilators and feeding tubes. This was determined by a Supreme Court decision called Cruzan et ux v. Director, Missouri Department of Health. There are also state laws that authorize an individual to name a person to make healthcare decisions for when he or she is unable to do so himself or herself. Advance directives are intended to ensure that a person’s wishes are known — and followed. Among other things, they allow a person to state wishes regarding the potential use of life-prolonging procedures. The necessary documents will be most helpful to survivors if wishes are discussed ahead of time with family members, friends and healthcare providers as part of advance care planning. The most common healthcare directive is the Power of Attorney for Health Care Decisions. It allows you to appoint a person to make healthcare decisions if you are incapacitated, and it also allows one to state wishes about issues such as life support and organ donation. The document would go into effect only when the creator of it cannot make or communicate decisions for himself or herself. When a person completes an advance directive, copies of it should be given to corresponding physicians, family members, clergy, attorneys, friends and other appropriate people. The details of the directive should be discussed. Whenever the person is hospitalized, a copy should accompany him or her. The person also should ask the doctor to make it a part of the permanent medical record. Contrary to what some might believe, an advance directive is valid in any state. However, because there are state-to-state differences, it is recommended that people have documents drawn up, witnessed and notarized in the state where they live. Advance directives then stay in effect until the creator’s death, unless that person revokes it ahead of then.

My father keeps asking to go home. What do we tell him? ? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

By Anthony Ferraro on

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.

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

By Anthony Ferraro on

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.

How beneficial can I consider a dementia care unit for my mother?

By Anthony Ferraro on

June 27, 2012

- Alzheimer's Care, Blog, Elder Law Articles

If it’s done well — with proper staffing and development — it can be very beneficial. The idea of the dementia care unit is to provide specialized care, which includes trained staff for dementia, smaller units to soothe residents’ feelings and a locked area that will be safe for those who wander or pace relentlessly. The last two are symptoms that most Alzheimer’s patients experience at one time or another. Dementia units do not try to stop it from happening but rather aim to contain it to a safe environment. If your mother lived in an open facility — not a specialized unit— she might become more confused. Many such facilities are larger, have wide open spaces and high ceilings, and a lot more people coming and going. Those conditions are virtually eliminated in a special care unit. Dementia units raise the level of care while lowering the levels of stimulation. Many have done away with overhead intercoms since they can cause serious confusion or agitation for residents. The standard for Alzheimer’s care in most facilities is that the special unit has its own activities director. Often, direct care staff also are trained specially to participate in resident activities, which are specifically geared to the residents’ needs. For more information on special Alzheimer’s care facilities in your area, contact your state’s Department on Aging. It can give you a list of units or tell you where you can find one. If you have the option, visit at least three of these units in your area before making a choice. As always when visiting a potential home for a loved one, take someone you know and respect who preferably isn’t in the family. That way you can get a more objective view of what’s going on. Meet the staff and observe how they treat the residents, and how the residents respond. It’s not unusual for a facility to have a few deficiencies, but how serious were they and have they been corrected in a timely manner? You need to know these things. When you make a decision about a facility for a loved one, listen to your gut feeling. It is often a very accurate way to gauge. You still need to take stock of basic needs and questions; talking with the person who accompanied you on your visit will help sort things out. Then you can make a rational decision that everyone can live with more comfortably. For more information regarding Alzheimer’s, click here.

Incontinence is starting to become a factor with my mother. What should I do?

By Anthony Ferraro on

May 24, 2012

- Alzheimer's Care, Blog, Elder Law Articles

This can be one of the more difficult aspects of dealing with Alzheimer’s. Beyond its usual challenges, incontinence typically sets in during the middle to late stages of the disease. It can be a permanent or temporary condition. Discuss the situation with your physician. Have him or her check for possible contributing conditions that could be causing the problem. This could include a bladder infection or urinary tract infection. Once health-related possibilities are ruled out, it can be assumed the condition has set in permanently. In that case, it’s time to consider incontinence products. By being prepared with proper adult briefs or other products, your mother can avert embarrassing episodes if she has an accident. Consult a physician or other clinician for how to deal with the incontinence — many people incorrectly stop trying to conduct regular bathroom visits just because their loved one is wearing a brief, for example. When a brief gets wet, it should be changed as quickly as possible, to avert skin irritation and breakdown. At this time, the skin should be thoroughly cleaned with a wet cloth and dried. Red or irritated skin can be a warning sign of further problems down the line. Observe this condition closely! Should sores begin to develop, seek immediate medical help! Nothing good comes of compromised skin integrity, and once it starts to go, it can be a quick decline. If your mother sits in one place for long periods of time, have her shift positions frequently to redistribute the pressure on affected areas. The weight should be repositioned somehow so it doesn’t remain in the same place for too long. Get your mother up and have her walk — even a short distance — around the house or yard. This will relieve pressure bearing areas and get blood recirculation, both of which are very helpful. Changing chairs and lying down (if previously seated) also can be helpful. If her physician writes an order for an evaluation from a home health agency, take it seriously. The agency can make home visits. A nurse will take stock of the overall situation and set a plan of action in place accordingly. These recommendations should help everyone involved — your loved one as the “patient” and you and others who are caregivers. More success will mean less stress, and that, too, is very desirable. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”

What’s the best way to communicate well with someone with Alzheimer’s?

By Anthony Ferraro on

May 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Good communication can help many problematic situations and behaviors, and even sometimes negate them. The No. 1 tip you can learn on this topic is to treat a loved one with Alzheimer’s as an individual with a disease, not as a diseased individual. The person has an entire, personal, individualized history that will stay with him or her throughout life’s journey. Some characteristics will never leave; some will become more pronounced. A high-anxiety person could still be tightly wound, while a laid back person could become even more so. Everyone needs to have his or her feelings validated, and individuals with Alzheimer’s are no different. In fact, they might need it even more, given their likely memory loss or possible insecurity issues. Here’s an example: You mother, who has Alzheimer’s is angry with your wife a lot of the time. They were on good terms in the past, but now she blames your wife for everything. You have to keep in mind that it is the dementia talking, not your mother. You can validate her feelings by saying, “I don’t blame you for being angry” and then move on. What she feels is real to her (even if it’s not true) and you should at least afford her some validation. Of course, you might have to coach your wife at this point, too. Reinforce that the comments and action aren’t necessarily against her at a personal level. It’s the nature of this devastating illness and, in the long run, is only a temporary condition. People who have Alzheimer’s respond well to affirmation so be generous with the praise and comments such as “good job” or “way to go,” etc. Here are some other tips to conducting good communication with your loved one (or anyone) who has Alzheimer’s:

Identify yourself when you begin a conversation. If he says he knows already, laugh and joke it off
Maintain eye contact when speaking
Slow down when you talk
Use short sentences
Smile and be pleasant
Be aware of her body language. A sudden change in position (i.e. sit-to-stand) could indicate the need to go to the restroom, or another form of discomforts
Be aware of YOUR body language. Try not to appear tense, upset or intimidating. Remember: The majority of communication is conveyed non-verbally
Don’t argue
Ask only one question at a time. Give enough time for responses. Yes/no questions are the best
Don’t talk about your loved one as if she or he weren’t there — you can never be sure of just how aware she or he might be. Also, don’t be condescending or order the person around
Try to avoid a high-pitched tone of voice. It could be interpreted as anger
When your loved one is upset and communication between you just isn’t working, try a hug. Soon, anger should be forgotten and you can try again
Use gentle touches to get your love one’s attention if necessary. You can try by putting your hand on his shoulder, knee or hand
Eliminate any noise that could be distracting, such as TV or radio. Go to another room to talk if it would be helpful.

For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”

How likely is it that my loved one with more lucid days and less lucid days with Alzheimer’s?

By Anthony Ferraro on

May 11, 2012

- Alzheimer's Care, Blog, Elder Law Articles

It is very likely he or she will be just like anyone else: The person will have good days and bad days, clearer days and foggier days. Sometimes it will seem like nothing is wrong; others, there will be no doubt Alzheimer’s is at work. On a good day, the person might remember things like he or she once did. Patients might appear upbeat and say they are feeling good. You should savor these times. Such lucidity is a blessing you should embrace. You might begin to question whether the Alzheimer’s diagnosis is accurate. This would be false hope. Realize these times should be savored, for they will pass. Caregivers tend to go through a grieving process and that can lead to fantasizing. It might seem like everything is just a bad dream, or that things will go back to the way they were one day. Denial might set in. We look forward to our loved ones “snapping out of it” any day. If and when lucid days come around, they can validate such fantasies. But then reality will hit us squarely between the eyes. While you must let yourself grieve, you also must remember to enjoy each moment of the good times. It might be a few good days, or even just a few moments. Enjoy them regardless! “Quality” is more important than “quantity.” This is what you have to remind yourself. If your quality time is limited, at least you have those moments to draw from. Look at them as a blessing — and look back to them to help you get through bad times. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”

Can I seriously consider being blessed to be a caregiver?

By Anthony Ferraro on

May 10, 2012

- Alzheimer's Care, Elder Law Articles

As devastating as Alzheimer’s is, you can look at it as a burden or a blessing. We cannot control so much of our life — like what people think of us or how they run their lives. Or whether we get a disease. But what we CAN control is our own reactions. While it might be very difficult, as a caregiver you must arrive at a place of acceptance. But you do not get there without grieving first. Grieving is undeniably a personal journey. Some people progress at a fast pace while others take longer periods at various stages. Some stages they might never experience. Grieving can consist of many emotions: Shock — You can’t think, speak or react after hearing the diagnosis Emotional outpouring — Yell, cry, even throw things at this stage Depression — Loneliness and a feeling of isolation set in Physical signs of distress — You might feel ill or extremely tired Anxiety — Worries about what’s going to happen in the future grip you Anger, hostility — You’re mad at the afflicted person, your family, doctors, even God. You then can feel guilty, especially for the anger you have directed at God Guilt — Your thoughts and feelings make you feel guilty, or you feel that you’re not doing enough as a caregiver Not keeping up with normal activities — You worry about how others will react or treat your loved one Healing of memories — You come to the slow realization that healing memories are often painful memories. This is the time to come to grips with what is happening and realize that life has to change if it’s going to continue. Feed off the good memories to keep you going. Acceptance — You start to accept you are in a new chapter of life. If you can accept that, you can get on with your life, and with much less stress. Realize that you will continue to grieve due to the ongoing changes with Alzheimer’s disease. Even when you might get to the “acceptance” stage, you won’t be at the end of the line — you might cycle through the stages again, or through just a few. This is normal. It will not mean you’re regressing or going backwards. Afford yourself a break. Let yourself feel. The blessings start to become apparent once you hit the “acceptance” stage. It’s said Alzheimer’s disease can be a person’s second chance in life. Inhibitions disappear. Patients become blatantly truthful, and often funny in the process. You did not ask for your loved one to have dementia, and you didn’t ask to care for her or him. This situation has been “given” to you. That means it is a gift to you. And you discover that your loved one also is a gift to you. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”