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Who are you caring for?
Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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You might call your local area agency on aging and/or your state health department, a local medical school if you have one nearby or an elder care attorney licensed in your state near where you live. Many states -- as well as local area agencies on aging or medical schools have -- "doctor home visit programs" for the frail elderly. An elder care attorney (perhaps the one who drafted your POA) may know of other physicians who do "at home" or "video visits" with the frail elderly. This may be one approach.
That said having worked "in an Alzheimer's wing" you know that a conclusive diagnosis about the type of dementia may be hard to get without various other medical imaging and/or other tests, but a physician trained in the general diagnosis of dementia and ruling out other things such as UTI, could be helpful.
Another question is where does the diagnosis lead. Is this a hope about a treatment option -- obviously that depends on the root cause as but there are not many except for a few that may delay further for a bit. Is the diagnosis needed for execution of the POA (?), is that needed for you to fully step in? Is the diagnosis needed perhaps for a facility permanent placement or seeking other benefits?
All to say how this is approached depends in part of what the diagnosis is needed for, other benefits and triggering of the POA then perhaps an elder care attorney is best to advise. If placement in a facility, then perhaps more of an Area Agency on Aging call if "she is NOT safe" and "you cannot safely provide care for her."
Perhaps another option is trickery (sorry), work out with a geriatric physician ahead of time. Tell her that you need to go to but you want her to come with you and as part of your assessment she needs to be there to answer questions too. Obviously, the appointment is really for her, but if you can use a bit of trickery to say it is for you as long as the doctor is in on it then that may be an option. I recommend a board certified geriatric physician as they often have lots of experience dealing with these situations whereas a regular family MD or internal med MD may not. My mom's geriatric internist works with both a geriatric psychiatrist and psychologist who can be helpful in handling the cognitive/psychological exams -- a huge starting point even if she won't go for any imaging tests -- later may be a bridge too far.
This is a sad/hard option, but an option. If she has a fall, her behavior becomes irrational/dangerous in that she is not mental or physically stable, call 911, say she fell/hit her head, is irrational, not safe. They can take her to the local ER for a basic assessment and imaging (if she hit her head). This basic imaging may be able to see if there are any TIAs (mini strokes that might rule out one problem). Obviously this is not a full neurological work up with contrast imaging nor other types of imaging, but it is something. The can do blood work and urinalysis (is there a UTI or other blood related indicators of other conditions that may mimic dementia or worsen it?). Make sure they know she is on no meds or won't take any, which is of concern. Urge them to admit her for 24 hours, tell them your concerns about clear cognitive decline/impairment/irrational behavior give examples, ask for a psych assessment too. Then as part of discharge refuse to take her back and insist on discharge to a Rehab hospital for physical and occupation therapy, maybe some emergency psychotherapy, medication management (if they put her on any Rx meds). If you have an elder care attorney see if they can help too work with the hospital social workers or area agency on aging for a Rehab stay at a facility that can also do the dementia work up there. I had to use this option w/my mom (84 then), the dementia work up was done/confirmed at the Rehab/SNF facility. Then, we go a permanent placement for her after a spend down. Good Luck w/this.
I'm so sorry that you are experiencing this struggle. Living with a spouse that has dementia is so difficult. Trying to problem-solve every day. Problems that seem to have no solution. Some people on this forum have told their spouses or loved ones that their medical insurance requires an annual physical with their primary care doctor or their insurance will be cancelled. Might be worth trying.....
Lie! Tell them that their prescriptions are up and need to go to the doctor to get them refilled. This is how I got my Daddy to go to the doctor everytime!
I would call your council on aging and talk to a social worker to see if they can have someone come into your home to analyze her for dementia. They can give you direction on who to call and what to to do. There are services in areas that can help you.
Hello, I’m sorry you are having difficulty with your wife. As you know It can be challenging on a daily basis to deal with someone in this situation. Other than a confirmation of Alzheimer’s, what good would it do to have her diagnosed? Unless a diagnosis is required to place her in an assisted living facility. Perhaps you might consider hiring someone to come in and provide you some relief a few days a week or for a few hours to get you out and about at least for a walk. It’s amazing what a little time away can do to help deal with the stress related to caregiving. I too know the signs and have an elderly husband that has not been diagnosed but clearly has vascular dementia. I shower, shave, dress and feed him daily and just roll with the flow as challenging as it can be, but I have been there for him for six and a half years. So in my opinion, if she is healthy otherwise I’m not sure it’s really necessary for her to see a doctor unless she clearly has other medical concerns that need attention. I wish you the best, but be sure to take care of yourself too.
There is nothing to be done about it from my experience. There is , however, a word for it; “anosognosia” and it means “without knowledge of disease”. Took me a week to learn to pronounce it correctly. I am slowly learning to, "let go and let God". One thing I did do was to make an appointment with her doctor and tell him what I was experiencing with her. Just a heads up so he could be tuned in to symptoms. As she has been failing she wants me with her during doctor appointments (even though she does not know who I am 80% of the time), so I make excuses to leave the room so he can evaluate her without me interfering.
So many great and caring answers to your question. Seems many of us have the same issues with this disease, the most prevalent is seeing Dr's. My wife refused to go. OK, so to remove that problem put her on Hospice In-Home Care. I didn't know it existed. I only knew Hospice came in at End Of Life Care. Since she wouldn't go, I took her with me to my appts, same doctor (previously set up). He engaged her in conversation and made a preliminary diagnosis. He ordered Hospice In-Home Care. Medicare and Supp Ins pays for it all. They are wonderful. So now she sees a highly-skilled nurse every week for her meds and health check up. If necessary, she can have weekly personal hygiene help, social worker, and spiritual connection. Hospice will pay for ALL the meds related to her diagnosis including her pain meds. They will also order her other meds but we still pay for them. Life is SO much easier not having to fight to get ready for appointments. In the end, the 'official' diagnosis doesn't matter unless you need it for the ridiculous insurance requirements. She refuses to give me a DPOA. During a rough patch in our marriage she gave her alcoholic son a DPOA and turned over financial control to him. In the next few years he stole over $62K from her retirement funds. She finally asked me to help find out what her finances were, that's when we found out. Thank God he committed suicide (yes, in this case it was a blessing) and she got most of it back. So now she refuses to give me one. Yes, it will be a huge problem down the road, but until then I'll make sure she is loved and cared for at home. Best to you in whatever decisions you make. It is really a disgrace that our government and insurance companies continue to extract their pound of flesh when we most need the help or better yet, be left alone!!
Hi there, I was wondering if you yourself have seen your Doctor? General check up stuff for yourself & to mention your concerns regarding your wife? Sometimes that can be a way forward. Hopefully the Doctor has suggestions for you? Or maybe you could bring your wife along to YOUR next appointment? The Doctor can just meet her, hopefully some build trust.
THanks but we both have the same Dr she just refuses to go and she currently is not taking any prescription medicines .I have talked to the doctor and he said he would need to see her but she refuses
I have been thru this with mom as well. Before the Dementia took hold, mom and I made an agreement that she would go to dr last year for UTI and physical, and she continues her macular shots. Otherwise she refuses to go. She does not want to be kept alive using artificial means. She wants to enjoy what she has, especially great grandchildren, and that it that. Don’t waste money on dentists as well - so we agreed as long as she is not in pain we let it go. She has friends who go to the dr literally every day. She doesn’t want that and her wishes are clear. Her dementia is progressing fairly quickly, I just realized the problem in December 2021.
So what will you do with a diagnosis? The key is to be patient and kind with your love one no matter what! When the time comes you can not care for them they may need a care facility. If anything you are the one who needs to get training. There will always be moments they can remember something just cherish those moments.
Yes this! Well said… my mom was never officially diagnosed. She did not want to go to the doctor and would have been miserable in the testing. She passed a week ago here at home and happy and we had no problems caring for her, only hospice at the end.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
You might call your local area agency on aging and/or your state health department, a local medical school if you have one nearby or an elder care attorney licensed in your state near where you live. Many states -- as well as local area agencies on aging or medical schools have -- "doctor home visit programs" for the frail elderly. An elder care attorney (perhaps the one who drafted your POA) may know of other physicians who do "at home" or "video visits" with the frail elderly. This may be one approach.
That said having worked "in an Alzheimer's wing" you know that a conclusive diagnosis about the type of dementia may be hard to get without various other medical imaging and/or other tests, but a physician trained in the general diagnosis of dementia and ruling out other things such as UTI, could be helpful.
Another question is where does the diagnosis lead. Is this a hope about a treatment option -- obviously that depends on the root cause as but there are not many except for a few that may delay further for a bit. Is the diagnosis needed for execution of the POA (?), is that needed for you to fully step in? Is the diagnosis needed perhaps for a facility permanent placement or seeking other benefits?
All to say how this is approached depends in part of what the diagnosis is needed for, other benefits and triggering of the POA then perhaps an elder care attorney is best to advise. If placement in a facility, then perhaps more of an Area Agency on Aging call if "she is NOT safe" and "you cannot safely provide care for her."
Perhaps another option is trickery (sorry), work out with a geriatric physician ahead of time. Tell her that you need to go to but you want her to come with you and as part of your assessment she needs to be there to answer questions too. Obviously, the appointment is really for her, but if you can use a bit of trickery to say it is for you as long as the doctor is in on it then that may be an option. I recommend a board certified geriatric physician as they often have lots of experience dealing with these situations whereas a regular family MD or internal med MD may not. My mom's geriatric internist works with both a geriatric psychiatrist and psychologist who can be helpful in handling the cognitive/psychological exams -- a huge starting point even if she won't go for any imaging tests -- later may be a bridge too far.
This is a sad/hard option, but an option. If she has a fall, her behavior becomes irrational/dangerous in that she is not mental or physically stable, call 911, say she fell/hit her head, is irrational, not safe. They can take her to the local ER for a basic assessment and imaging (if she hit her head). This basic imaging may be able to see if there are any TIAs (mini strokes that might rule out one problem). Obviously this is not a full neurological work up with contrast imaging nor other types of imaging, but it is something. The can do blood work and urinalysis (is there a UTI or other blood related indicators of other conditions that may mimic dementia or worsen it?). Make sure they know she is on no meds or won't take any, which is of concern. Urge them to admit her for 24 hours, tell them your concerns about clear cognitive decline/impairment/irrational behavior give examples, ask for a psych assessment too. Then as part of discharge refuse to take her back and insist on discharge to a Rehab hospital for physical and occupation therapy, maybe some emergency psychotherapy, medication management (if they put her on any Rx meds). If you have an elder care attorney see if they can help too work with the hospital social workers or area agency on aging for a Rehab stay at a facility that can also do the dementia work up there. I had to use this option w/my mom (84 then), the dementia work up was done/confirmed at the Rehab/SNF facility. Then, we go a permanent placement for her after a spend down. Good Luck w/this.
Perhaps you might consider hiring someone to come in and provide you some relief a few days a week or for a few hours to get you out and about at least for a walk. It’s amazing what a little time away can do to help deal with the stress related to caregiving.
I too know the signs and have an elderly husband that has not been diagnosed but clearly has vascular dementia. I shower, shave, dress and feed him daily and just roll with the flow as challenging as it can be, but I have been there for him for six and a half years. So in my opinion, if she is healthy otherwise I’m not sure it’s really necessary for her to see a doctor unless she clearly has other medical concerns that need attention.
I wish you the best, but be sure to take care of yourself too.
There is nothing to be done about it from my experience. There is , however, a word for it;
“anosognosia” and it means “without knowledge of disease”. Took me a week to learn to pronounce it correctly. I am slowly learning to, "let go and let God". One thing I did do was to make an appointment with her doctor and tell him what I was experiencing with her. Just a heads up so he could be tuned in to symptoms. As she has been failing she wants me with her during doctor appointments (even though she does not know who I am 80% of the time), so I make excuses to leave the room so he can evaluate her without me interfering.
Cindy
Her dementia is progressing fairly quickly, I just realized the problem in December 2021.