How to Plan for the Future with a Loved One with Dementia

Though medical researchers are developing tests to detect dementia earlier, today it may take years for the symptoms to become readily apparent. But in the meantime, adult children and caregivers of aging seniors can begin preparing by learning about dementia and planning for the care of their loved ones.

Even if dementia never touches your senior, many of the steps taken to deal with it are beneficial for seniors with diminished cognitive and physical skills.

Take Time to Plan Ahead

Facing dementia early on is important because an early diagnosis means gaining access to treatments that can possibly slow the disease progression. Also, it provides more time to learn about the dementia, find support, and prepare for the future. Having conversations with your senior prior to significant cognitive decline enables him or her to express their wishes about the care they will receive.

You will not be able to predict everything that may happen, but there are some things you can do to prepare. If you wait to react to problems rather than being proactive, decisions will need to be made in haste and under extreme stress in many cases.

What to Look For

Alzheimer’s disease is the best known form of dementia. There are several others, too. Some share the same symptoms as Alzheimer’s, and some have their own unique effects on the brain and body.

In general, in the beginning stages of dementia, the senior may have some minor memory problems, but these are difficult to distinguish from natural age-related memory loss.

As the disease progresses, thinking skills diminish. Seniors may have trouble finding the right word to express themselves. Planning and organizational skills begin to wane, and remembering new information becomes more of a challenge. At this stage, physicians can administer tests to detect impaired cognitive function due to dementia.

As dementia becomes more debilitating, the loss of financial management abilities, math skills, and short-term memory capacity become apparent. The inability to recall basic information surfaces, like the address of the home. The senior may dress inappropriately, putting on too many clothes on a warm day. Caregiving will have to become more comprehensive as confusion increases.

Final stages are marked by a severe decline which includes personality changes, inability to remember most details of personal history, the need for assistance in taking medications, dressing, using the toilet, bathing and other daily activities become necessary. The senior may wander away from the home. Obviously at this stage, caregivers are needed 7 days a week, 24 hours a day, and the care should probably be provided by professionals, either in the home or at a skilled nursing facility.

Eventually, the disease is terminal.

Support for Planning for the Future with a Loved One with Dementia

There is much more to know about dementia that will help your senior and your family. With dementia, learning and preparing never ends.

The Alzheimer’s Association provides a wealth of information, including ALZConnected, a virtual community of caregivers with message boards and solution pages.

There are many other books, brochures, and websites to access as well. You can find some support resources right here, on Bethesda’s blog.

The senior’s physician and other medical professionals, including home health services staff can share their insights, expertise, and experience with adult children and caregivers. Also, attend health care provider screenings and appointments with your loved one. Listen closely and ask questions.

Build a Support System

If the family is providing the caregiving, a network of people is vital. It is a mistake for one person to take on the task alone. The details of maintaining the home—lawn care, housework, laundry, etc.—can be overwhelming while also dealing with the challenges presented by dementia. Talk to family and friends, and create a written agreement about who is willing to perform certain tasks.

One family member may take on financial responsibilities, see that bills are paid and cash flow is managed. Another friend or family member might provide transportation to medical appointments. Someone else could grocery shop, another person could prepare or bring in meals at times. Perhaps someone would agree to improve the safety of the home to reduce the possibility of accidents and injuries. And one of the most beneficial services is to simply stay in the home for a while and give the primary caregiver a chance to get away or complete other tasks.

Meet with this network regularly. Discuss what is and isn’t working and make adjustments. As dementia progresses, needs will change.

Make a Financial and Legal Plan

While your senior is still able to clearly express their wishes someone should be designated as having financial power of attorney and someone having medical power of attorney to see that finances and medical decisions are in keeping with the desires of the senior.

Also, some determination about how care will be paid for has to be made. Will the parents’ savings be enough? What other financial resources are available to pay for care? Is the family willing to contribute financially, or will other sources of income have to be found?

Create a Care Plan

A care plan includes meal planning and daily activities for the senior. Also, a schedule for medications needs to be established. The caregiver should work with physicians and therapists, going to the appointments to hear what the health care professionals are recommending, and keep them updated on the senior’s condition.

The same physical and emotional health considerations for optimal wellbeing apply to a senior with dementia as to any other person:

• weight management
• blood pressure control
• good nutrition
• regular exercise
• following medication regimens
• mentally stimulating activities
• companionship

If someone in the family has a medical background this might be the role for them to help with.

Consider a Care Manager

If all of the above sounds daunting, it can be. But there is another resource you can access.

A care manager is a trained and experienced professional who can help a family with a large number of details, including navigating the health care system and creating a customized care plan, insurance details, advanced directives, government entitlement programs, and veteran’s benefits. Also, as a member of a care management team, the care manager can bring a comprehensive array of physical and personal care services into the home.

As the need for care becomes more extensive, the care manager can recommend and provide additional services, including placement in a skilled nursing facility.

At Bethesda, we understand the challenges that family members of those with dementia encounter. Our mission is to provide exceptional care to meet the unique needs of a senior and their caregivers. Explore our memory support services and our Care Management program to learn how our team of Care Coordinators can support you and put together a customized plan for your loved one.