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Which best describes their mobility?
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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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Wondering if things like cancer screenings, peticures, pain management doctors and rehab need to be pulled back as she becomes less functional. For example if cancer returns do you treat given everything else?
My priorities would be to manage the pain first. When you're in chronic pain, life has no joy. Everything is managed AROUND the pain, whereas if it's well controlled, then life is better all around.
Yes to the mood-stabilizer meds. I wish mom had been on AD's all her life. She would have been so much happier. My MIL also--but she refused them saying she wasn't 'crazy'. I'm hoping younger generations have more insight into their mental health.
Yes to the foot care. My DH is so tall he cannot reach his own feet :) I have been caring for his toenails for 25+ years. I sleep with him and a I have many a wound from him accidentally kicking me with a sharp toenail! Also, it's just a good part of hygiene and personal care. He has some neuropathy in his feet, so I keep a close eye on any 'hotspots' or sores. He adores a good foot rub, and it's good for his feet, too.
Some drugs can and should be dxed. My mom was mixing daddy's Lipitor with applesauce the last year of his life even while he was on Hospice! When we found out she was doing this--we helped her to see it was pointless at this point. He wound up on comfort meds only.
I am a cancer survivor and have already made the decision that when/if it comes back, I am going to go gentle into that goodnight. My kids have already had their say about that--they want me to fight--but based on the first round of it--a second round would ruin me and I don't want to go through that again.
As we age, we really need to look at what meds are helping us and what are actually 'holding us back'. Cholesterol meds. after a certain age, are pointless. BP meds also--although if they also provide comfort, then continue. Infections should be treated. (again, that's a comfort thing).
We have the ability now to keep people out of pain and we shouldn't be afraid to talk about it and use the available meds. The 'opioid crisis' does not extend to our elders who really need the meds.
Staying in close contact with your LO's PCP and having open dialogue about what is necessary and what is not as they age is important. If your LO can no longer make decisions appropriately, then sometimes family must step in and have a voice.
If it was my mom, I would definitely keep up with the podiatrist, that's important for your moms comfort.
I would discontinue the cancer screenings, I see no point in them after health is already failing. And I would not treat cancer, chemo is so hard on the body.
Definitely continue the pain management.
Best of luck, so sorry about your moms declining health. 🙏
Medicare pays for a podiatrist to cute toenails. Moms came to her AL.
Pain management should not stop. Cancer screenings, yes if you do not plan on treating the cancer. My Mom went to a urologist for bladder cancer. Over 5 years cancer free he was still doing scopes in her mid 80s, I stopped that. Mom went to a couple of specialists, once she was stable visits only became every 6 months or a year. Once in a NH, they stopped. PCP only if sick or needed a refill.
Sometimes a PCP can take over once a person is stabilized. If on cholesterol medication I would stop it. It contributes to Dementia and damagesvthe liver.
Definitely yes to pain management and meds for depression/mood/anxiety.
Yes to pedicures. My Aunt was 100 with advanced dementia but could still get into a salon chair for her pedi. Toenail and foot care becomes more difficult as one ages. Plus she still enjoyed the pampering and socializing. It's the "cheapest" useful treatment one can get at that stage in life.
Cancer screenings? No. Other lab work and testing? No. Eye exam? No.
Dentist? It depends on the situation and whether your Mom can cooperate and tolerate some discomfort while remaining still during the work, and even get into a position where the dentist could work on her. Obviously if something is causing her pain, it needs attention.
Rehab? Probably not. Like others have pointed out, your Mom needs to be able to do the exercises, cooperate, and make progress.
My 105-yr old Aunt (who has very good cognition and memory) still lives in her own home with the help of 2 family caregivers. She is actually very healthy. Her primary doc basically told her at her last wellness appointment not to come back! (He was semi joking). Seriously, my Aunt doesn't even want us to call 911 if she fell or had a medical emergency.
I would keep the thing your mom enjoys like the pedicures(that is if she enjoys them, I know I do)and of course pain management, which can be done through hospice if needed, as you don't want her suffering in pain. There does come a point in ones dementia journey where less is more and keeping things as simple as possible goes a long way. So yes, cut back on all doctors appointments and any further testing or treatments and just let your mom live out her days as comfortable and pain free as possible.
I have this argument with a sibling. He insists my mom should go, but then he doesn't listen to what the doctor says, so in the end what's the point of even going? A person with dementia can't make her own care decisions.
I had to go to accompany them to a recent neurologist appointment(this i view necessary) and because i was there and asked the right questions the doctor is increasing the dose of one of her medicines.
My dad didn’t have dementia but certainly had way too many doctors and appointments, many of them became increasingly useless. I wish I’d have stopped the dermatologist, rehab, urologist, and maybe a couple more far sooner. Dad’s toenails were too thick for him to cut, so the sweet lady at the nail salon was definitely a keeper. The cardiologist had the wisdom to recommend hospice, definitely a keeper. Short answer, if they bring value, keep. If they just make you come and you can’t find value, dump them
I'm gonna take the last first. Would you treat if cancer returned? Would mom understand the testing, would she understand chemo and or radiation? Any surgery quite often leads to a decline due to the anesthesia. My gut response would be no treatment. Unless there is pain and in that case minimal treatment to lessen the pain. And a call to Hospice.
Pedicures. I mom enjoys them and she can sit for a length of time go for it. If it gets to a point where she can not sit in the chair or follow directions then cut them out.
Pain management. You have to manage pain. there are problems with drugs that manage pain, generally they make a person a fall risk. So she needs to be more closely monitored.
Rehab. If she can follow directions, follow through with instructions then rehab can help in many ways. If she can not follow through, can not follow directions then there is no point in rehab.
You do not give any info but you might want to contact Hospice and see if she is eligible for Hospice or if you do not want to start there a Palliative Care visit might be a way to begin, they can let you know when she becomes eligible for hospice. With Hospice you will get a Nurse to visit weekly, check health status and the Nurse will order medications and medical supplies. . A CNA that will come 2 times a week for a bath or shower and to order personal supplies. When the need arises they will order equipment that will make caring for her safer for both of you. (Hospital bed (get that asap) and any equipment to help with transfers. Part of the Hospice Team includes a Chaplain, a Social Worker and you can request a Volunteer that can come sit with mom while you run errands.
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.
Yes to the mood-stabilizer meds. I wish mom had been on AD's all her life. She would have been so much happier. My MIL also--but she refused them saying she wasn't 'crazy'. I'm hoping younger generations have more insight into their mental health.
Yes to the foot care. My DH is so tall he cannot reach his own feet :) I have been caring for his toenails for 25+ years. I sleep with him and a I have many a wound from him accidentally kicking me with a sharp toenail! Also, it's just a good part of hygiene and personal care. He has some neuropathy in his feet, so I keep a close eye on any 'hotspots' or sores. He adores a good foot rub, and it's good for his feet, too.
Some drugs can and should be dxed. My mom was mixing daddy's Lipitor with applesauce the last year of his life even while he was on Hospice! When we found out she was doing this--we helped her to see it was pointless at this point. He wound up on comfort meds only.
I am a cancer survivor and have already made the decision that when/if it comes back, I am going to go gentle into that goodnight. My kids have already had their say about that--they want me to fight--but based on the first round of it--a second round would ruin me and I don't want to go through that again.
As we age, we really need to look at what meds are helping us and what are actually 'holding us back'. Cholesterol meds. after a certain age, are pointless. BP meds also--although if they also provide comfort, then continue. Infections should be treated. (again, that's a comfort thing).
We have the ability now to keep people out of pain and we shouldn't be afraid to talk about it and use the available meds. The 'opioid crisis' does not extend to our elders who really need the meds.
Staying in close contact with your LO's PCP and having open dialogue about what is necessary and what is not as they age is important. If your LO can no longer make decisions appropriately, then sometimes family must step in and have a voice.
I would discontinue the cancer screenings, I see no point in them after health is already failing. And I would not treat cancer, chemo is so hard on the body.
Definitely continue the pain management.
Best of luck, so sorry about your moms declining health. 🙏
Pain management should not stop. Cancer screenings, yes if you do not plan on treating the cancer. My Mom went to a urologist for bladder cancer. Over 5 years cancer free he was still doing scopes in her mid 80s, I stopped that. Mom went to a couple of specialists, once she was stable visits only became every 6 months or a year. Once in a NH, they stopped. PCP only if sick or needed a refill.
Sometimes a PCP can take over once a person is stabilized. If on cholesterol medication I would stop it. It contributes to Dementia and damagesvthe liver.
Yes to pedicures. My Aunt was 100 with advanced dementia but could still get into a salon chair for her pedi. Toenail and foot care becomes more difficult as one ages. Plus she still enjoyed the pampering and socializing. It's the "cheapest" useful treatment one can get at that stage in life.
Cancer screenings? No. Other lab work and testing? No. Eye exam? No.
Dentist? It depends on the situation and whether your Mom can cooperate and tolerate some discomfort while remaining still during the work, and even get into a position where the dentist could work on her. Obviously if something is causing her pain, it needs attention.
Rehab? Probably not. Like others have pointed out, your Mom needs to be able to do the exercises, cooperate, and make progress.
My 105-yr old Aunt (who has very good cognition and memory) still lives in her own home with the help of 2 family caregivers. She is actually very healthy. Her primary doc basically told her at her last wellness appointment not to come back! (He was semi joking). Seriously, my Aunt doesn't even want us to call 911 if she fell or had a medical emergency.
There does come a point in ones dementia journey where less is more and keeping things as simple as possible goes a long way.
So yes, cut back on all doctors appointments and any further testing or treatments and just let your mom live out her days as comfortable and pain free as possible.
I had to go to accompany them to a recent neurologist appointment(this i view necessary) and because i was there and asked the right questions the doctor is increasing the dose of one of her medicines.
Would you treat if cancer returned? Would mom understand the testing, would she understand chemo and or radiation? Any surgery quite often leads to a decline due to the anesthesia.
My gut response would be no treatment. Unless there is pain and in that case minimal treatment to lessen the pain.
And a call to Hospice.
Pedicures. I mom enjoys them and she can sit for a length of time go for it. If it gets to a point where she can not sit in the chair or follow directions then cut them out.
Pain management. You have to manage pain. there are problems with drugs that manage pain, generally they make a person a fall risk. So she needs to be more closely monitored.
Rehab. If she can follow directions, follow through with instructions then rehab can help in many ways. If she can not follow through, can not follow directions then there is no point in rehab.
You do not give any info but you might want to contact Hospice and see if she is eligible for Hospice or if you do not want to start there a Palliative Care visit might be a way to begin, they can let you know when she becomes eligible for hospice.
With Hospice you will get a Nurse to visit weekly, check health status and the Nurse will order medications and medical supplies. . A CNA that will come 2 times a week for a bath or shower and to order personal supplies.
When the need arises they will order equipment that will make caring for her safer for both of you. (Hospital bed (get that asap) and any equipment to help with transfers.
Part of the Hospice Team includes a Chaplain, a Social Worker and you can request a Volunteer that can come sit with mom while you run errands.