Law Forum : Options In Caring For Elderly Parents With Dementia

Discussion in 'Law Forum - Prisons - Gun Ownership' started by cherryblossom, Mar 12, 2010.

  1. cherryblossom

    cherryblossom Banned MEMBER

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    http://www.caring.com/questions/what-is-the-difference-between-power-of-attorney-and-conservatorship
     
  2. cherryblossom

    cherryblossom Banned MEMBER

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    Becoming Your Parents' Guardian
    Conservatorship is a Drastic Step in Elder Care
    Aug 21, 2008 Fraser Sherman


    When your parents become unable to manage their own affairs—whether because of dementia, accident or illness—you may have to become their legal guardian. Guardianship—or conservatorship, as it's called in some states—turns over full control of their money to you. You control their investments, give them an allowance, and can even decide whether to sell their house.

    Some state restrict guardianship to specific powers: Parents who can't manage their money might still be competent to decide where they want to live, so their guardian's power would reflect that.....


    Involuntary guardianship
    Your parents may not admit they can’t handle their affairs, or they may be so far gone mentally they can’t give you authorization. In that case, you will have to petition the court for an involuntary guardianship. This will not be easy.

    The default assumption is that anyone over 18 is competent to take care of themselves, so if you want involuntary guardianship, the burden of proof is on you. Even if your father is blowing his retirement fund to gamble and take girlfriends on luxury vacations, foolish spending isn’t grounds for the courts to give you control of his checkbook. If your parents are even minimally competent, the chance of securing guardianship is slim—and the chance of alienating your parents by trying is very high.

    Competency hearings
    To secure involuntary guardianship requires a court hearing to determine competency. Your expenses will include an attorney and possibly psychiatrists, social workers and investigators to review the case and evaluate your parents. You’ll receive guardianship if the court finds your parents can’t make informed decisions on personal or financial matters and that failure to appoint a guardian would create an unreasonable risk to your parents' health and safety.

    Even if the judge decides to appoint a guardian, the judge isn’t required to give you that power, or even a member of your family. And you will have to make regular reports to the court to make sure you’re not abusing your authority.



    FULL ARTICLE HERE
     
  3. Seksen

    Seksen Well-Known Member MEMBER

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    I appreciate this information that you have presented to help people think ahead to the needs of loved ones and family members. I have done some research and found out that many diseases can be reversed including some if not most symptoms of Alzheimer's Disease. This I think would be good for the patient and the care giver. If ones health could be extended or symptoms lessened to a greater state of restored health. This Dr. was sewed by the FDA for making claims that nutrition and mineral deficiencies were the cause of most disease and health problems that we suffer from. After litigation and trial studies over a period of years he was awarded $20,000,000.00 (20 million dollars) because he was proven right and the FDA was proven to be wrong. This is just another tool to add to your arsenal of tools and information to help the aging population of which I am a member of also. Peace
     
  4. MimiBelle

    MimiBelle Well-Known Member MEMBER

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    I've a few thoughts....

    For a long while and into the 20th century - in this country and around the world - our mentally ill were warehoused, treated as subhuman and subjected to physical, mental and sexual abuse.
    There is much about mental illness that was not known until recently. .
    When the first dx'd case of Alzheimer's - a woman - came about in the early twentieth century, it was initially written off as a mental illness. Wasn't until they 'autopsied' her body that they saw something that picqued their interest. But...the late and early stages of AD do mimick a mental disorder.
    Of course, no one would catch that it was something different.
    Until that point, they didn't look.

    All in all, people get on my nerves stoking this conspiracy talk.
    We're talking early 20th century, here. How 'medically advanced' does everyone think we were back then? We're talking about a time when kids actually died from polio, chicken pox and whooping cough. A time when people actually died from syphillis. In the 50's, men were dropping like flies from HTN and HF...and no one understand the dangers of cigarette smoke or alchohol.
    I mean - the medical community JUST figured out how to create effective birth control.

    How 'medically advanced' does everyone think we are now when, even today, a definite dx of AD can only be had via autopsy?

    So, I think it a little disingenuous of this speaker to just say offhand, "Oh, only recently hase AD been an issue...and that's mighty strange'...and blah, blah, blah. Frankly, it just pisses me off that he'd gloss over this to prove a point.

    It's well-known in medical circles that lifestyle modifications could do much to relieve the occurrence of cardiovascular disorders (and the like). That's not news. The healthcare community's been preaching 'diet, exercise and moderation'...and 'the dangers of cholesterol' for the better half of 70 years and people still do what they want.

    My thoughts on the matter? Nothing to do with this doctor and his FDA battle.

    I'm simply against breeding false hope.

    What kind of research?
    ...by what means can AD be reversed?
    There are new developments. There may be 'lifestyle modifications' that might be able to 'decrease' susceptibility, but nothing in the way of a cure.
    *shrug*

    ANYWHO--
    Dementia? It's chronic, debilitating and pretty much irreversible.
    Again - I'm not into spreading false hope.
    The individual will forget...make up things to fill the gaps and feel frustration because of it. The illness will progress to a point where the individual loses insight into their memory loss and, as such, becomes unaware of it. They may hide things. They may wander. They'll end up bedbound or in a w/c. There will be a steep decline in intellectual function.
    They won't be able to feed themselves. They won't be continent. They won't be able to speak. They won't respond.
    They won't recognize you, the loved one.

    The job of caregiver is a difficult one. Dementia is...well - no words to describe that. But - to deal with the matter is to deal with reality. It'll tear the caregiver up inside - they will not cope properly - if they anticipate miracles that will never come. If they refuse to deal with the situation as is, that is.

    **********************

    As a caregiver, your goal is to maintain the highest level of functioning possible as their abilities gradually diminish.
    Some tips:

    -- TAKE CARE OF YOURSELF, CAREGIVER.
    It's ok to take a break. Get some help if you need it. A home-health aide or nurse to come in for a few hours would be nice. Seek out a support group. It takes a lot of love and dedication and balls to fill that role. ...'specially in the end.

    -- Elder-proof your home.
    They will wander about...and if they were very active when young? They tend to wander more. Sometimes, it's goal-directed.
    Keep them safe. New locks on the door. A security system. A Bed alarm, maybe.
    Don't try to keep them from wandering. Just try to keep the environment safe enough for wandering.
    ...and, of course, a few general safety tips for elders in the home:
    Install handles and rails in the bathroom. Remove clutter. Remove area rugs and put on their feet, the socks with the rubber soles on the bottom...to keep them from falling. Use night-lights to help them see their way around.
    Shiny floors are pretty, but carpet is always better.

    -- Redirect.
    When they're agitated and angry? Don't argue. Redirect your loved one to another discussion. Guide them to another activity. They'll forget very quickly what they were ever angry about. When they don't want to shower/bathe. Come back in 5 minutes and try again.
    It's also helpful to remember - particularly in the early stages - that, in general, people tend to act out in anger when they feel out of control. The elder is no different. The elder with AD/dementia is no different.

    -- Encourage proper sleep-wake patterns
    Keep them up in the day. This will help them sleep at night. If they wake at night, do what you can to get them back to sleep. Sing, give them a dolly. Rub their back and give warm milk. Something...

    -- Don't Re-Orient them to reality.
    AD/DEMENTIA is about the only exception to this rule, however.***SIDENOTE SEE BELOW.
    It is fine to feed into their fantasies, so to speak. Let's say... your parent is wandering and mentions looking for their mother or deceased spouse..because they are 'getting ready to go to the wedding' or something along those lines. Don't break that reverie. Don't orient them to reality.
    "Ma, dad's dead."
    No.
    *laugh*
    Such a thing could depress them, frustrate them...they may lash out in anger. Can you really blame them? Wherever they are in that happy fantasy is a helluva better than what's killing them at present.

    -- Watch for signs of depression in the early stages.
    They forget things and are angry because they forget. It frustrates then. Maybe they begin to feel worthless and sad. It especially strikes those who were high-achievers particularly hard.
    It's natural to feel down about such a thing but do what you can to identify it and help them cope.
    Depression can actually make AD worse.

    -- Encourage self care at whatever level they can function.
    Don't push. Do what's within their ability to do. It creates stress for them to perform...when they can't.
    If they can eat, but are unable to manipulate utensils? You can, maybe, try the thick utensils that stroke victims use. http://www.caregiverproducts.com/site/270651/page/911595/stroke-products
    Or...just give them finger foods. If there are no contraindications, high protein + high carb foods are ok. Give in small, frequent meals...and, of course, offer fluids throughout the day.

    -- Give your loved one simple, clear directions.
    It's not, "Ok, daddy - we need to be at church. Put your clothes on."
    It's more like, "Daddy. Put your arm in this sleeve. Good. Now, put the Lt arm in the sleeve."

    -- Watch the bedsores.
    When mobility is gone? Change them and reposition their bodies EVERY 1.5 to 2 HOURS, without fail.
    If they're in a w/c, shift them around in that chair every hour.
    Protect the bony parts of their bodies with padding.
    http://morganna.qondio.com/prevent-pressure-ulcers-for-bedbound-patients
    Exercise their limbs and make sure that they're getting their fiber and drinking plenty of fluids.

    -- Your loved on is not their illness.
    Speak softly. Be kind. When they're 'off the rails' and agitated. It's not them.
    Even the most impaired individual can sense compassion in their caregiver. I believe this and I've seen as much in my professional career to know that it's true.
    I work with elders at one of my gigs and, while it's always brief? It always gives me the warm fuzzies when they 'snap out of it'. That's the moment that they actually look at you with recognition...which is always a surprise to me because I usually deal with some having never seen them in their lucid and aware state.
    So, I'm in the room about to do a skin assessment.
    Set up. Pulled back the curtain. Tried to rouse her from sleep. "Ms. Dorothy...hey? Ms Dorothy. Wake up, mama... I'm gonna look at your skin, ok?"
    Her eyes open. Seemingly unfocused on nothing, as usual.
    I bring the chair over and said in a sing-song voice, "Heeey, Miss Dooo-tty...."

    She looks up with the biggest grin on her face, actually makes eye contact and says as clear as a bell, "Hey, darlin`!"
    What the heck?
    I was all 'screetchy' by now. So, I said practically squealing, "Ms. Dotty?! Hey, mama! How are you?" and I laughed.
    She laughed, too.

    What... the heck?
    She was 'with it'.

    Until that point, our communication had pretty much been...uh, one-sided? *laugh*
    Like, I'll go in there to do her nail care or something like that?
    ...and I'll just be yacking my head off. Making jokes that only I find funny. Talking s--t about my fiance. "...and Ms Dotty? Girrrl, lemme tell you...."
    Current events. "I don't know what I'm gonna eat for lunch, Ms Dotty. I can't believe Jack n the Box discontinued the Jackaccinoes...."
    Discussing the weather and my shoes. "I really hope it doesn't rain this afternoon. I hate driving home in the rain. Everytime it rains, y'know... Like, last time it rained? Tell me why 'Imelda' had the dogs out? I come home to a house smelling like 'fresh, wet dog' and 3 dirty little dogs tracking prints on the floors...and y'know I have chihuahua's, right? They're not outside dogs and when they go out in rainy weather? Put the booties on 'em! I dunno why she put 'em out, anyway. They're crate/pad trained and I keep boxes of pads in the washroom. Like... why would you do that? Ugh. She just makes my nerves so bad. She probably did it on purpose...like she dropped my mixer on purpose and broke it. I told 'Julian' and he still won't fire her. But - that's ok. That is ok because... guess what? Something happens to one of my dogs? It's on."

    'Miss Dotty' knows 'all the business'.
    *laugh*
    She'll be there. Listening in her own way. Blowing spit bubbles and whatnot. Y'know... *shrug*
    I know when she's listening b/c she stops babbling when I speak. "Der, der, der, der, der...."

    They need that, though. My yacking. It's therapeutic. Some don't have radios and tv's and so - they need that human interaction. We usually don't have a lot of time, but I try.
    I almost wanted to say, 'welcome back'! *laugh*


    **************************

    SIDeNOTE***This is not to be confused with the reality orientation done with those who have delirium or those who are dealing with manifestions, i.e., hallucinations/delusions, etc... of a psychotic disorder, i.e., schizophrenia, schizoaffective...or other, i.e, alcoholic withdrawal, depression, and bipolar disorder.
    Bipolar I, to be exact.
    'Mania' does not manifest with Bipolar II. HOWEVER, it can brought on if the meds are mismanaged or the 'therapeutic levels' are off.
    For instance, if you were to give a BP II pt an anti-depressant and no mood stabilizer (Lithium)? They'll probably be going all 'off the rails', because they don't have anything to level them out.

    And...I'm talking about this because....
    *shrug*
    Might be someone out there whose loved one has schizophrenia...and the like

    ANYWHO---
    Imagine if every time you turned around, you saw half-demon beasts ...or a snake in your bed...or you talked to a lady for hours on end that no one else could see...or you're afraid to open packages or eat food that hasn't been wrapped for fear that someone is trying to poison you...or you're afraid to go to the grocery store because you believe that you can 'hear' other people's thoughts.

    Well - that's what those with hallucinations/delusions go through.
    It's weird. On one hand, they aren't crazy...but the delusions eventually drive them bonkers.
    The meds don't help, sadly...and the fact that most with mental illnesses have compliancy issues doesn't help. Everytime they re-start? It fragments their mind.
    ...and the fact that they frequently self-medicate with drugs to take the voices and visions away REALLY doesn't help. I've a woman right now (BP/Schizoaffective disorder) whose kidney's are shutting down after years of her gobbling up her pills every time she suffered a delusion.
    She just wants relief. Poor baby.
    Antipsych meds are hard on the body. She won't last outside of a year.
    It's sad.
    But...

    You don't reinforce the delusional belief.
    You simply say, "I know that you see them, but I don't see anything." or "These voices must be frightening/interesting for you...but I don't hear them."
    The point (which is a component of reality-based treatment) is to HELP the individual discern the difference between what's real and what's not. Unlike Dementia, delusions/hallucinations are the core of what's wrong with the schizophrenic, for instance. You want to constantly shed light on that illogical thinking.
    They cannnot tell the difference.

    Lastly, they may hear, see, feel and smell things that aren't there. If they mention that 'voices' speak to them? Always, always, ALWAYS assess 'command' voices.
    "How do these voices sound?" ; "Are they friendly or malevolent?" ; "Do they scare you?" ; "What do you hear?" ; "Do they tell you to do things?" ; "Do they tell you to hurt yourself?" ; "Do they tell you to hurt...others?"
    Always.

    Anyone ever watch 'A Beautiful Mind...the movie about the mathematician and Nobel winner?
    That's what you might call a high-functioning schizo...and they do exist. He couldn't have made it that far without the support of his caregiver (his wife) who helped him work through his illness, however.
     
  5. NNQueen

    NNQueen going above and beyond PREMIUM MEMBER

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    Sister MimiBelle,

    Reading this literally brought tears to my eyes as you describe AD and Dementia and caretakers. I have my own story about what it was like to care for my mother, who was diagnosed with Dementia. In two weeks, it will be four years since she passed and I was with her for three years prior, taking care of her as she once took care of me.

    I won't tell the whole story but it was the scariest yet most fulfilling time of my life, to be in a position where I could care for my mother the way that I did. Although I was deeply saddened as I watched her struggle to remember or to do simple things for herself, as I look back now, it was truly and honor for me to show her how much I loved her by taking care of her.

    The toughest part for me was taking care of myself during the process. I actually THOUGHT that I was, but as soon as I watched her draw her final breath, I immediately recognized that I hadn't. I was so intense about caring for her every need, I failed to take care of my own. It was as though I was living for two people, instead of one. I was on the clock 24/7. I don't and never will regret taking care of my mother the way that I did, but I know now, there's a better way to do that without losing yourself in the process.

    Thank you for making me smile as I read your comments. Thank you for your passion about and compassion for our people.

    :heart:
     
  6. Clyde C Coger Jr

    Clyde C Coger Jr going above and beyond PREMIUM MEMBER

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    In addition ...


    2 things you can do to reduce your risk of dementia


    ... The best thing you can do for your health is to get up and get moving! According to research, active seniors have a 50 percent lower risk of developing Alzheimer's disease or dementia.

    Don't fret if you hate exercising — all you need is 30 minutes of activity a day. You don't need to torture yourself on a treadmill — you can take a walk in the park or even go for a jog with your dog. Find an activity that you actually like to do and it will help make exercising much more enjoyable! ...



    http://www.today.com/series/30-seco...-you-can-do-reduce-your-risk-dementia-t101079

    [​IMG]

    There may not be a cure to dementia, but there are ways you can reduce your risk


    ...


     
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