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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?
Acknowledgment of Disclosures and Authorization
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.
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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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I put extensive dental care and surgeries for eyes and hernias in this category too. My grandmother had a surgery- that resulted in a stroke from the stress, we probably should have skipped it. Another friend had a mom with a broken femur that cascaded through many decisions, some which did not change the outcome at all. Once all the bedsore care begins, there is lots of pressure for extensive antibiotic use and sadly they basically become a human petri dish for antibiotic resistant organisms sitting in your home or care home. I can talk about this now because i am currently under no pressure to make any of these decisions. Check back with me in 3 years and I will be speaking with a different tone, because it will be more personal for my mom. The only one I am dealing with now is that she can not swallow her pills and is kind of chokey in the dental care. We can overcome those.
Linda, you are right that there are several aspects to this topic. Once a decision is made that certain medications should be taken, then a practical way has to be devised to ensure the person with dementia gets them as directed.
Another aspect is deciding which drugs the person should have. In early stage dementia there are some drugs that can reduce certain symptoms and thereby improve the quality of life. These do not prolong life, just make life a little less unpleasant. As you say, dementia is terminal but over a long period of time. Decisions about what drugs to continue with and which ones to drop should be thought out carefully, and may change over time, as the dementia progresses.
Personally, my husband and I make decisions about his medications based on whether they are for quality of life or for prolonging life. Surprisingly this isn't always straight-forward. I asked a cardiologist about a heart medication, for example. In terms of preventing a heart-attack, it would be viewed as extending life, but the drug also acts to reduce the chance of a stroke. Having a stroke along with dementia is definitely worth trying to avoid -- at least in my mind. Hubby still takes that pill. He has a pacemaker -- that is a comfort issue. He has had his defibrolater removed -- that is a life-prolonging measure.
Abu09, if your mother doesn't want to continue taking her prescriptions because, knowing she has dementia, she doesn't want to prolong her life, I would respect that. But I would also go over all of the meds carefully to make sure she knows what they do. Our geriatrician was wonderful in doing this with all of my husband's pills at the beginning and also answering any questions along the way. (We've been on this journey 8+ years). Your mother may have many more years to live. Improving the quality of those years seems a reasonable goal.
Perhaps I have read your question differently than the others. There is some decision making that needs to happen about quality of life once someone has a progressive cureless disease. Anti- biotics, heart medicines, vaccines, diabetes regimes, sobriety, they all take on different meanings once the person is terminal. The problem is dementia is SLOW to progress. For counsel you may consider speaking with a hospice volunteer. They have a different perspective from the primary care doctor or the care home who profits from the unnecessary extension of life. I broached this topic with my brothers and they were not willing to talk.
Somehow it will now be up to a dementia-free person to insure she takes her medicine. Maybe it can be done with a phone call, but the only way you will really know she is following Dr.'s orders is for a responsible party to oversee this. Maybe a neighbor or close friend of your Mom's. Also, can the schedule be structured to accommodate the individual. I thought my mom was taking her medicine as directed (not even diagnosed with dementia at this point) and she became dependent on a pain drug for her back.
This is an issue many caregivers have while caring for their loved ones. Below are two great article that will help you manage your mom's medication that the doctor prescribed for her.
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.
Once all the bedsore care begins, there is lots of pressure for extensive antibiotic use and sadly they basically become a human petri dish for antibiotic resistant organisms sitting in your home or care home.
I can talk about this now because i am currently under no pressure to make any of these decisions. Check back with me in 3 years and I will be speaking with a different tone, because it will be more personal for my mom.
The only one I am dealing with now is that she can not swallow her pills and is kind of chokey in the dental care. We can overcome those.
Another aspect is deciding which drugs the person should have. In early stage dementia there are some drugs that can reduce certain symptoms and thereby improve the quality of life. These do not prolong life, just make life a little less unpleasant. As you say, dementia is terminal but over a long period of time. Decisions about what drugs to continue with and which ones to drop should be thought out carefully, and may change over time, as the dementia progresses.
Personally, my husband and I make decisions about his medications based on whether they are for quality of life or for prolonging life. Surprisingly this isn't always straight-forward. I asked a cardiologist about a heart medication, for example. In terms of preventing a heart-attack, it would be viewed as extending life, but the drug also acts to reduce the chance of a stroke. Having a stroke along with dementia is definitely worth trying to avoid -- at least in my mind. Hubby still takes that pill. He has a pacemaker -- that is a comfort issue. He has had his defibrolater removed -- that is a life-prolonging measure.
Abu09, if your mother doesn't want to continue taking her prescriptions because, knowing she has dementia, she doesn't want to prolong her life, I would respect that. But I would also go over all of the meds carefully to make sure she knows what they do. Our geriatrician was wonderful in doing this with all of my husband's pills at the beginning and also answering any questions along the way. (We've been on this journey 8+ years). Your mother may have many more years to live. Improving the quality of those years seems a reasonable goal.
There is some decision making that needs to happen about quality of life once someone has a progressive cureless disease.
Anti- biotics, heart medicines, vaccines, diabetes regimes, sobriety, they all take on different meanings once the person is terminal. The problem is dementia is SLOW to progress.
For counsel you may consider speaking with a hospice volunteer. They have a different perspective from the primary care doctor or the care home who profits from the unnecessary extension of life.
I broached this topic with my brothers and they were not willing to talk.
This is an issue many caregivers have while caring for their loved ones. Below are two great article that will help you manage your mom's medication that the doctor prescribed for her.
Guide for Managing Medications and Prescriptions
https://www.agingcare.com/articles/Managing-Medications-and-Prescriptions-133678.htm
and
Top 6 Medication Problems and How to Prevent Them
https://www.agingcare.com/articles/medication-problems-elderly-people-have-146111.htm
Hope this helps! Good Luck :)
Karie H.
AgingCare.com Team