Facing The Facts of a Parent’s Decline
Sooner or later many families face the problems of an aging parent’s decline, such as creeping dementia or decreased physical mobility. It’s not pleasant to see that once strong and vibrant parent slowly lose the ability to be independent, and a big impediment to planning and getting a medical diagnosis is both the parents and the adult children being in denial.
A thorough medical evaluation by a gerontologist is a wise place to start. It provides direction for better living choices, for safety, for medications for memory issues, and for in home care to insure the parent is in a safe and appropriate living environment. Over the years people get prescriptions for all types of ailments. These prescriptions become quite a cocktail of drugs, all of which have side effects and which may not always interact well. These need to be evaluated carefully by a physician who is knowledgeable and attentive to the interplay of different drugs. A deceased aunt of mine was on nine different medications. My cousin, an academic research doctor, took her to live with him and over a year and a half weaned her from all of her prescriptions. That is an extreme example, but in her case, resulted in better mental performance and a better quality of life.
If there are signs that memory is becoming a problem, such as leaving the stove on, then make an appointment with the gerontologist, to specifically address your concerns. That evaluation will give a baseline, and what to expect going forward. The earlier the issues of memory, judgment and physical deficits are addressed, the greater the probability of keeping parents functioning in the best living environment possible.
A family once called us because mom had phoned the police to report a strange man in her bed. Although the family did see the humor in this sad situation, they had been hoping against hope that her Alzheimer’s would progress slowly. They immediately took steps to get mom medication to ease anxiety, and got help in the home, for her sake and for dad’s, so that he would not constantly be under stress.
Developing A Plan To Protect A Parent's Physical, Financial, and Legal Well Being
When it becomes apparent to the family that a parent will not be able to live alone without medical or physical help, a long range plan should be developed. That includes the physical, financial and legal aspects of getting care. The physical part is what kind and amount of care is needed. Can it be a home, in an apartment, or an assisted living facility? Maybe day care could give the well parent a few hours break to get relief from a spouse that demands constant attention.
The financial is the cost of care and how to afford the cost of care, between family assets, the VA Aid and Attendance Program, or one of the programs available under the Connecticut Home Care Program for Elders, which at the high end includes Medicaid (Title 19). As this column has reported many times, Connecticut has good home care programs compared to many states, but is one of the strictest in terms of eligibility and that is where the legal comes in.
The legal means having the legal tools in place that will allow family members to make medical and financial decisions, to transfer assets in keeping with the eligibility rules, and to handle any kind of assets including real estate, investments, IRAs, and bank accounts that a married couple may own. It also means having the appropriate estate planning documents in place. For example, a Connecticut Supreme Court decision ruled that spouses can do wills with a trust built into the wills that substantially protects all the assets in the “healthy” spouses name if the healthy spouse should die before the one needing care. That is true even if the “sick” spouse is already on Medicaid.
Alzheimer’s and other diseases that ravage the mind or body may not have a cure, but there are better ways and worse ways to deal with the real life effects. Families that recognize the impending issues and address those issues as early as possible have a far greater chance of taking care of dad and mom in a safe and decent living environment, and preserving assets and sanity for them and the rest of the family. Hopefully your parents will not suffer those very debilitating diseases, but if they do, facing the reality early can make the best of a difficult and trying decline.