Posts Tagged ‘Care Planning’
Common Sense Caregiving by Gary Joseph LeBlanc: A must read for anyone caring for a loved one with Alzheimer’s
A columnist and book dealer from Spring Hill Florida Gary Joseph LeBlanc offers a personal and down to earth account of his experience caring for his father who suffered from Alzheimer’s disease. This common sense account of is a must read for anyone caring for a loved one with Alzheimer’s disease. Written as a completion of sixty-five articles from his column, LeBlanc gives an encouraging and enlightening guide for anyone navigating the turbulent waters of caring for a loved one with Alzheimer’s disease.
Discussing End of Life Care (Part 2)
In part one of this two part series, we looked at the different types of advance directives people can establish to ensure that their end-of-life care is in line with their wishes. Today, we look at how to talk to your loved ones and encourage them to express their wishes so that as they approach the end of their life, you as the caregiver know exactly how to proceed.
Although there are always different techniques for approaching this conversation, there does seem to be one common opinion: the time to do it is now. “Everyone over the age of 18 should have a health care proxy form filled out and should be discussing what they would want done with a person that would be making decisions for them in the event that they are not able to make these decisions for themselves,” said Fern Wasserman, Founder of New York Legal Nurse Consultants. New York Legal Nurse Consultants helps facilitate conversations between the individual filling out their health care proxy form and the people who will need to carry out these wishes in the event this person is unable to make their wishes known.
Colleen Reynolds, President of Edge Communications and former admissions and marketing coordinator of a skilled nursing facility in Fort Myers, Fla., also emphasizes that time is of the essence. “I’d suggest that the Healthcare POA/Surrogate be discussed well in advance of needing it. A DNR should be gently discussed, but discussed again when the decision is imminent,” she said. “I watched so many people struggle with this decision and family members who wished desperately that loved ones asked for a DNR after they had been resuscitated and then left to suffer brain damage and broken ribs.”
In Reynolds’s work, she had to have these conversations with patients who did not have any advance directives on file. “Because the conversations didn’t happen earlier, it was often left up to me to talk to someone who was admitted, if they were not declared legally incompetent, to see if they wanted to be resuscitated in the event of heart failure. Strangers should not have to do this.”
Medication Log
Use this tool to monitor changes made to your loved one’s medications over time. The type, date and effects of these changes can be recorded and monitored between doctor visits. This log can then be brought to future doctor appointments to track the negative and positive side affects to further alter dosages to ensure the right use of each medication individually as well as the effects of all the medications taken together as a group.
Sample Log ↓
| Start Date: | 12/10/08 |
| Medications For: | Joe Walker, Sr. |
| Log Prepared By: | Joe Walker, Jr. |
| Brand Name: | Seroquel |
| Generic Name: | Quetiapine fumarate |
| Date Prescribed (mo/yr): | January, 2009 |
| Doctor: | Dr. Ryan Smith |
| Pharmacy: | CVS – Boston |
| Monthly Cost: | $50 |
| Reason: | Dementia – Delusions |
| Date | Dosage | Doses Daily | Times of Day | Observations | ||||||||
| 1/13/09 | 50 MG | 2 |
|
Seems to be doing better, a little tired mid-day. |
||||||||
| 5/20/09 | 100 MG | 2 |
|
Dosage increased by Dr. Smith at appointment on 4/15/09. Increased dosage is managing delusions better. Still somewhat tired after taking morning dosage. |
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Encouraging Loved Ones to Give Up The Keys
For many who are beginning the process of aging, the ability to drive can be the first that needs to be scaled back to ensure safety. Since driving requires physical ability, quick reaction times, and directional planning, there are many different reasons that an elder may no longer be physically capable of driving. Worst of all, it’s usually the biggest detriment to the elder’s sense of independence, requiring them to always plan appointments or simple trips to the grocery store around a spouse or adult child’s schedule. Convincing a loved one that they are putting themselves and others in danger if they continue to drive must be handled delicately to ensure that they will take the advice to heart.
The Alzheimer’s Reading Room posted a terrific article and Podcast with Carole Larkin, a geriatric care manager who specializes in dementia, being interviewed by Max Wallack, advising caregivers on how to carefully explain that they should stop driving. Larkin gives tips on how to frame your conversation to ensure that the loved one is not hurt by the accusation that they are no longer capable of such a high level of functioning, but rather to show concern for their safety. She also explains what options are available if the loved one is still resisting giving up the keys.
Readers: Have you had this conversation with a loved one? What techniques worked? Did you have to resort to legal methods to get your loved one to stop driving? Tell us in the comments!
The Risk of CCRCs
A new Government Accountability Office report advises consumers that Continuing-Care Retirement Communities’ (CCRC) high entry cost can also put residents at a high level of financial risk, the Wall Street Journal reports. The average entrance fee for a unit at a CCRC is $249,857, according to the National Investment Center for the Seniors Housing and Care Industry. After this entrance fee, there are also monthly fees that are assessed depending on the level of care a resident needs and the type of contract they have signed. When a resident moves out of a facility or passes away, many contracts will state that they will not be refunded all or part of their entrance fee until after the CCRC has found another tenant.
In addition to the delay in having the entrance fee refunded, patients may find their entrance fee tangled up in bankruptcy proceedings. The Wall Street Journal article links to guides from CARF International (link www.carf.org) and The American Association of Homes and Services for the Aging (link www.aahsa.org). They suggest getting a copy of the facility’s audited financial statements and analyze aspects like the facility’s days of cash on hand and their cash-to-debt ratio.
Readers: Have you or a loved one lived at a CCRC that had financial difficulty, or conversely, was very lucrative? Do you work in a facility in either category? What do you notice about the ones that are successful – are there traits that other CCRCs can learn from?