Thank you for taking our Online Assessment.
Based on the feedback you’ve provided us so far, and our years of experience in working with hundreds of families, this is your customized assessment report. The information provided below will give you confidence you’re heading in the right direction toward the best solution for you or your loved one.
Enlist support of a care management company like LifeLinks Care to manage your care plan. When reading these recommendations, or trying to implement them, you may feel overwhelmed or unsure about where to start. A Care Manager can help you prioritize the needs, point you in the right direction and even implement as much or as little of the plan as you want.
For ongoing peace of mind, once the situation has stabilized, a Care Manager can provide routine status checks, scheduled according to your needs, for ongoing assessment.
Regular visits will enable Life-Links to competently and quickly advocate for and support the patient, as needs arise.
In consultation with the appropriate decision makers, your Care Manager can manage your support services and healthcare including but not limited to scheduling appointments, arranging transportation, attending medical appointments, providing written reports, communicating with physicians and improving continuity of care through increased communication and advocacy.
Anytime you need a recommendation to the best provider of a specific service, you’ll need to get in touch with a Care Manager. The best assisted living facility for Susan’s mom, may not be the best one for your dad. Additionally, providers’ quality can change with new leadership or policies. We’ll need to meet your aging loved one, get to know them and their needs better and before applying our years of experience and current knowledge about who is providing the best service at this time.
Dementia vs Depression
Identifying depression in someone with dementia can be difficult, since dementia can cause some of the same symptoms. Examples of symptoms common to both depression and dementia include:
•Loss of interest in activities and hobbies
In addition, the cognitive impairment experienced by people with dementia often makes it difficult for them to articulate their sadness, hopelessness, guilt and other feelings associated with depression.
Depression in people with dementia doesn’t always look like depression in people without dementia. Here are some ways that depression in a person with dementia may be different:
•May be less severe
•May not last as long and symptoms may come and go
•The person with dementia may be less likely to talk about or attempt suicide
Read more at alz.org
Depression is a common problem among older adults, but it is not a normal part of aging. It may be overlooked because for some older adults who have depression, sadness is not their main symptom. They may have other, less obvious symptoms of depression or they may not be willing to talk about their feelings. Therefore, others may be less likely to recognize the symptoms as depression.
Different people have different symptoms. Some symptoms of depression include:
•Feeling sad or “empty”
•Feeling hopeless, irritable, anxious, or guilty
•Loss of interest in favorite activities
•Feeling very tired
•Not being able to concentrate or remember details
•Not being able to sleep, or sleeping too much
•Overeating, or not wanting to eat at all
•Thoughts of suicide, suicide attempts
•Aches or pains, headaches, cramps, or digestive problems.
For older adults who experience depression for the first time later in life, the depression may be related to changes that occur in the brain and body as a person ages. Depression can also co-occur with other serious medical illnesses such as diabetes, cancer, heart disease, and Parkinson’s disease. Depression can make these conditions worse, and vice versa. Sometimes, medications taken for these illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.
Dementia is the generic word for a set of symptoms indicating a decline in mental ability severe enough to interfere with daily life. Types of dementia include Alzheimer’s, vascular, Lewy-body and Parkinson’s.
While symptoms of dementia can vary greatly, at least two of the following core mental functions must be significantly impaired to be considered dementia:
•Communication and language
•Ability to focus and pay attention
•Reasoning and judgment
People with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood.
Many dementias are progressive, meaning symptoms start out slowly and gradually get worse. If you or a loved one is experiencing memory difficulties or other changes in thinking skills, don’t ignore them. See a doctor soon to determine the cause. Professional evaluation may detect a treatable condition. And even if symptoms suggest dementia, early diagnosis allows a person to get the maximum benefit from available treatments and provides an opportunity to volunteer for clinical trials or studies. It also provides time to plan for the future.
A Care Manager can help find the best doctor for this evaluation and facilitate an appointment.
Read more at alz.org.
Senior Living Communities
Explore moving to a senior housing community. The patient would benefit from living in an environment that provides more consistent social opportunities, such as a senior living community. Recent studies of cognitive health have shown that socialization provides better cognitive stimulation than individual intellectual stimulation such as crossword puzzles or Sudoku. Caregivers in the home can meet many medical or caregiving needs, but, in our experience, they do not often meet the need for stimulating conversation at the level and variety at which the patient is capable of conversing.
The following are good general rules of thumb to use in considering a level of care:
Independent Living – Usually a freestanding apartment building with month-to-month rent that usually provides one meal per day, weekly housekeeping, scheduled transportation and lots of on-site activities and of-site trips. Most often, seniors chose this option when meal preparation becomes cumbersome, they feel isolated at home and/or they stop driving. Some Continuing Care Retirement Communities have a significant entrance fee plus a monthly fee; many free-standing buildings offer month-to-month rentals.
Support services, such as medical home health care and hospice can be accessed from outside companies for temporary needs and are covered by Medicare. Non-medical, in home care and Aging Life Care™ Management can be implemented to assist the person in any areas of deficit. These services are paid for privately unless covered specifically by a Long Term Care Insurance policy. The cost of non-medical, in-home care for 10 hours or more every day is approximately the same cost as assisted living.
Assisted Living – It’s estimated that one million Americans currently live in Assisted Living Facilities. Residents may suffer from memory disorders, or simply need help with mobility, incontinence or other challenges. Assisted Living is appropriate for anyone who can no longer manage to live on their own but does not require extensive medical care.
Assisted Living Facility residents may need help with activities of daily living, including:
· medication management
· getting around
· monitor smoking
· nurse usually available 24/7
If a senior needs a number of services, an Assisted Living Facility may become a more economical alternative to home care services. For example, the cost of non-medical, in-home care for 10 hours or more every day is approximately the same cost as assisted living. Support services, such as hospice and geriatric care management, can be implemented to address special situations.
An Assisted Living Facility is often the first stop for an elder who needs to get help with daily living. According to fire safety guidelines, a person who lives in an assisted living facility must be able to evacuate the building on their own in 13 minutes or less.
Apartments are rented on a month-to-month basis and the fee usually includes 3 meals per day, weekly housekeeping, 24-hour staff and a nurse available, scheduled transportation and on-site activities. Extra fees are usually charged for medication management and assistance with activities of daily living. Support services, such as medical home health care, hospice and geriatric care management, can be implemented to address special situations.
Paying for assisted living:
· Medicare – no
· Medicaid – few
· Long term care insurance – some
A care management service like LifeLinks can help you identify, tour and decide which is the best community for your loved one.
Nursing Home, Long Term Care Facility, Health Care Center
A Nursing Home setting is ideal for seniors who:
•Can no longer get themselves in or out of bed;
•Have a complicated medical or psychiatric condition requiring nursing assessment 24/7;
•Need to be fed, dressed and/or bathed.
If the home setting or assisted living setting is requiring a lot of trips to the doctor or the emergency room, it is probably time to move to a nursing home.
Support services, such as hospice and Aging Life Care™ management, can be implemented to address special situations.
Paying for nursing home care:
•Medicare – only for short term, skilled stays in a rehab facility
•Medicaid – some
•Long term care insurance – yes
•VA benefits – yes
Professional Bill Pay
Consider assistance from a professional bill paying service. An experienced, licensed CPA could professionally oversee your loved one’s finances by implementing secure and customized bill paying including budgeting, cash flow management, monthly and annual reporting, and records management.
Consider a driving evaluation. Due to cognitive deficits, the patient is at risk. Consider a professional driving evaluation such as offered by medical facilities (not the DMV).
These evaluations are often administered by an occupational therapist for seniors that have cognitive decline or stroke, or other medical situations. With a doctor’s order, Medicare will pay for most of the evaluation. Care Management services like LifeLinks Care can facilitate getting an appointment.
Medication Management System
Implement a medication management system as soon as possible. Aging loved ones are often prescribed a significant number of medications for significant medical concerns. Taking these correctly is difficult for someone with this level of cognitive impairment which will continue to decline. Taking too much or too little of these medications can significantly affect one’s health.
A system should be implemented to include
•a nurse to weekly or bi-weekly set up medications in an organizer
•someone to remind and observe them being taken every morning and every night
•Philips offers a medication machine that can be filled for dosing that will be able to track how the patient is missing medications. Because it dispenses the medication, it would also prevent the patient from taking the medications at the wrong time or all at one time. Read more about the Philips automated medication management system at managemypills.com.
•Care management companies like LifeLinks Care can assist with the ordering or implementation of this system.
Review Legal Paperwork
Review legal paperwork for validity and appropriateness. We recommend all clients have a minimum of the following forms completed and up to date:
•Durable Power of Attorney (finances)
•Advance Care Plan OR Living Will AND Health Care Power of Attorney (Healthcare agent/surrogate)
•If in a facility, Physician’s Order for Scope of Treatment (POST form)
Ensure each of the people named in these documents are aware of the request, that a primary and secondary person are named in each document and at least one of the people named in each document is of a younger generation than the client. A care management company such as LifeLinks Care can recommend attorneys to assist with the Will and Durable Power of Attorney. The health decision forms can often be downloaded free of charge from your state government’s website.
Read more at nhdd.org
Often physical, emotional or social changes in our clients’ lifestyles, mean they choose fast food or tasteless frozen entrees instead of healthy nutritious meals. Today, many food delivery and personal chef services are available. They can create customized menus from gourmet to down home comfort food and deliver it to your home. They provide balanced meals custom designed to fit your specific nutritional needs and help you create a healthy lifestyle. You can describe your likes, your dislikes, and any special dietary needs or restrictions. Using these guidelines, they will carefully select and customize a wide variety of seasonal recipes to fit your specific needs incorporating fresh ingredients from local sources. They take care of all the shopping, food preparation, cooking, and clean up. Everything is prepared in their commercial kitchen and delivered fresh to your refrigerator and freezer. A Care Manager can make specific recommendations about providers in your area.
Elder Law Attorney
Elder law attorneys specialize in understanding the complicated laws around Medicaid planning, end of life decisions, veterans benefits and asset dispersion following death.
Benefits – Most Americans will quickly exhaust their savings and may need government assistance in paying for long term care. Medicaid will only pay for long term care if a senior (65 or over) meets medical guidelines as well as tests for income and assets. Fortunately, for the spouse who does not need nursing home care, the “community spouse,” there are ways to preserve assets so that he or she is not utterly impoverished. If the person needing nursing home care is not married, there are still ways to spend money that will help that person preserve a better living standard and perhaps some assets. Preservation of assets in these situations is time sensitive, and a family facing nursing home admission should contact an elder lawyer, who specializes in Medicaid planning, without delay..
Medicaid also provides home and community based services in most states for those who meet medical and financial guidelines. As with nursing home admission, it is important to get a plan in place as soon as possible before assets are completely used up providing for services.
The Veterans Administration offers Aid and Attendance as part of an “Improved Pension” Benefit that is not well known. This benefit allows Veterans and surviving spouses who need help with activities of daily living to receive additional money to pay for home care, or care in assisted living or nursing home facilities. Aid and Attendance is not dependent upon service-related injuries.
Documents – Although none of us plans to be ill or incapacitated, we owe it to ourselves and our families to plan for these circumstances. That is why every careful adult needs to have the basic documents (powers of attorney for financial and health care decisions) in place to allow those they trust to make health and financial decisions in case he or she is incapacitated.
Conservatorships/Guardianships – If your loved one is making potentially dangerous decisions and cannot be reasoned with, it may be time to consider asking the court for a guardianship or conservatorship, depending on your state. Sometimes a court has to intervene when a person becomes incapacitated and there are no powers of attorney in place to permit someone else to make financial and health care decisions. If a physician certifies the need for a conservator or guardian, a court can appoint someone to handle finances and health care.
Read more at naela.org
Senior Move Manager
Schedule an introductory meeting with a Senior Move Manager. Partnering with professionals who understand your situation and help you implement a “master plan” of action will alleviate stress. An initial consultation usually costs nothing. They will take the time to explain how they can help you get organized now while preparing for a move in a few weeks or a few years. They can help a little or a lot to declutter, sort, organize, pack, move and resettle. Moving from one house to another is a stressful event, whether you are moving to a smaller home, senior living community or remodeling your existing home. They will organize and handle your entire move with the utmost care and respect.
The National Association of Senior Move Managers will help you find a move manager in your area.
Hire professional caregivers in the home. Due to the client’s cognitive status the patient may benefit from caregivers in the home 3-4 times a week to ensure a shower is being taken, meds are properly taken, meals are prepared and she is eating the prepared meals. We strongly recommend using a licensed agency to provide these services rather than hiring individuals because the agency then assumes the responsibility for payroll taxes, drug testing, background screening and relief caregivers. A local or virtual care manager like LifeLinks Care can recommend agencies that have a proven track record with clients and as well as oversee their services.
Seek assistance from a Certified Aging-In-Place Specialist (CAPS). Professionals with the CAPS designation have been trained by the National Association of Home Builders (NAHB) in the unique needs of the older population, Aging-in-Place home modifications, common remodeling projects, and solutions to common barriers. CAPS professionals pledge to live out the CAPS Code of Ethics, complete continuing education requirements, and participate in community service events to maintain their designation from NAHB.
They can complete a comprehensive evaluation of your home and identify areas for improvement based on your current and projected needs. Working within your budget, a CAPS professional can prioritize the most pressing issues to be addressed and pair you with experienced remodelers and handymen. During the remodeling process they act as your advocate to ensure that the remodeler and handymen deliver the highest quality of service.
Consider engaging services of a counselor. Due to issues related to loss (loved ones, independence, cognitive abilities, purpose), older adults often benefit from talking to a counselor about their feelings and developing coping strategies. A local or virtual care manager like LifeLinks Care can recommend counselors who specialize in aging issues and coordinate scheduling appointments and transportation.
When doctors predict a patient has six months or less to live, they often say there’s nothing more that can be done. Yet hospice care, a Medicare benefit, can do many things to increase comfort, peace-of-mind and opportunities to help those final months be lived more fully, wherever the patient calls home. Most families say their only regret in involving hospice is that they waited too late.
Hospice care is designed to meet physical, emotional and spiritual needs and wishes of the patient and family, with services provided by a compassionate, expert team working together to meet goals of care. Services include:
Expert medical care – An attending physician supervises the overall care plan. Registered nurses make regularly scheduled visits and are available by phone 24 hours a day, 7 days a week.
Prescriptions, equipment and supplies – Most medications, equipment and supplies related to the terminal illness are included and are delivered right to the patient’s home.
Emotional and spiritual support – The entire family has access to counseling from social workers and spiritual care from chaplains.
Assistance with daily living – Home health aides assist several times per week with bathing, grooming, changing bed linens and other activities of day-to-day life related directly to the patient.
Companionship and respite – Specially trained volunteers provide occasional companionship to patients, run errands for the family or give family caregivers a break.
A Care Manager can be especially helpful to the spouse of the terminal patient. Helping him or her adjust to a new life after the spouse’s passing can be extremely difficult and important, and an experience Care Manager has walked beside many others on the same journey.
Obtain an appointment with a neurologist or geriatric psychiatrist. the patient shows significant signs of considerable memory loss and or depression. These professionals can help narrow down the cause and prescribe treatments and medication to treat depression, as well as treat the symptoms and possibly slow the progression of dementia related diseases.