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Hello! I apologize if this is listed under the wrong topic! Last night my family got my grandmother into a memory care unit at an assisted living facility. Over the course of the last several years, as I've talked to people at work, I've seen that so many of my coworkers are struggling with all of the issues surrounding elder care and dementia care and trying to make sense of everything while balancing the demands of their own family obligations, work, health issues, etc. The information is there, but it's hard to find at times, extremely complex and we're often in a state of emotional upheaval when we're trying to navigate the system. So as the leader of our corporate wellness team, I'm going to create a series of after-work, one hour workshops to address things like the differences between the types of care, understanding Medicare/Medicaid, in home care and it's benefits/shortcomings, POA, navigating family disagreements, etc. I want to end the series with a workshop built around the idea "how can I make things easier for my kids as I age."


I'm really interested to know what each of you sees as being essential topics to include in the series. What do you wish you would have known when you started on this journey? What nugget of information helped the most? This forum has been a huge and invaluable source of knowledge and a place from which I drew much strength in developing my advocacy skills. I want to arm my coworkers with the tools to make the tough decisions they'll face. Your help is irreplaceable.

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Gmadorisylove, you have touched on a topic of passion for me! Our blended family went through a dumpster fire of chaos when we eventually figured out that my MIL and stepFIL's mental, physical and financial situation was collapsing all at the same time. The adult children were in our late 40's early 50's, we all had full-time jobs, kids in school, and we had no experience at all (yet) with senior issues, Medicare, Medicaid, social services, PoA, nursing homes, etc. I worked through my in-laws' issues almost full-time for 1-1/2 years to get them situated on all fronts, and learned a lot the hard way.

I thought seriously about starting a blog, but the problem is nobody really knows that they are "going to have a problem" until the problem begins, and then it's a mess and often too late. So how to get the word out to people to care about a pending storm when they don't think the storm even exists? This website has been a blessing in this regard, even though it's "after the fact". Better than nothing!

But I love your idea of doing it through your corporation as a seminar! May I suggest that what you title the seminar will be very important so that people will understand how this important info will benefit them and their LOs. The seminar not only makes things easier for their kids, it will make things easier for themselves. Also, please realize there are many more problems for people who do not have children or close relatives on whom they can rely! It is even more important for those people to get decisions made and legal ducks in a row earlier.

There is a lot of poor or no planning, romanticized/unrealistic notions of aging, full-on denial and special issues for those whose parents/LOs have issues such as alcoholism, mental illness, etc. Please make sure your seminar is geared for EVERYONE, not just those with children. Also, the older employees who attend this seminar may already be dealing with THEIR own aging parents or are on the cusp of doing so. Be ready to address their questions or have a follow-up seminar. Again, don't be surprised if this seminar is met with a yawn. People are not interested in the unsexy topic of aging, decline, dementia (ew!!) etc. and have wildly romanticized ideas of how they will be living out their post-retirement years. Do sent out a teaser in the seminar announcement that lists facts that will get their attention:

- XX% of Americans do not have the basic legal documents in place that allow LOs to help care for them
"This seminar outlines what those documents are, where you can find help for planning, and what happens if someone does not have those documents and then become incapacitated."

- statistics on dementia (because we are now living so long); facts about dementia; actual stories from actual people (you can anonymize some of the stories from this forum -- plenty to choose from!!)

- Is it ever "too late" to prepare? Yes and no! Important facts and how they WILL impact your senior years.

etc.

Something to this effect. People need to know the why such and such is important and what then happens if preparations are not made BEFORE a person tilts into dementia or physical impairment. No one knows when decline begins. No one believes it's going to be them or their (currently) healthy "fiercely independent" parent(s). It's the bad news/good news seminar. I wish you all the best! God bless you for recognizing the importance of this topic!
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disgustedtoo Jan 2020
"...because we are now living so long..."

While this may be partially true, there are many who live to extended ages and show no signs, yet others are not even of early retirement age. The various dementias don't care how old you are. I do think more people should be made aware that this can happen to younger people too.

In my mother's MC facility, I was/am not aware of everyone's age (none of my business), but of those I did know, there were quite a few in their low-mid 70s, and at least 2 who are only early 60s. One woman, who was more on the ball than many, including my mother, moved in at age 99 and almost made it to 101! A bad fall was the probable cause of her demise.

I feel so bad for those who are younger, as they ARE being cheated out of their "golden" years. Mom had a good long run - it would be better NOT to have developed dementia, but at least she got 90+ years before that (she is 96 now, but not out of it yet.) She and my dad had a GREAT and LONG retirement!
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Brilliant! This is exactly the type of information I'm looking for! To anyone who answers - please know that I will be working diligently to see how I can incorporate your thoughts into my seminars. Oh - and my plan is to do a SERIES of seminars so we can really look at each topic and explore that topic in a one-hour format. So, for example, dementia and dementia care would be one hour, Legal documents - the difference between guardianship and POA, rights, responsibilities, how to get one put in place, etc - would be one hour, and so on.

Thank you, Geaton777, for responding! Interested to know, now that you see it's a series, what you would title the series, and what series topics you think would be most valuable.
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Ha! The title of the seminar should be, "Why you absolutely must come to a seminar you think you don't need." ;-)

or, "Nobody gets out of here alive. Is your exit plan based in reality? Do you even have a plan??"

or, "Aging gracefully is B.S. Now what?"

or, "Statistics prove you probably aren't going to die peacefully in your sleep so you better come to this seminar."

or, "The 'I'm-never-going-to-age-or-die-so-I-don't-need-this-seminar' Seminar"

These are all tongue-in-cheek but you get my drift that the title needs to be somewhat arresting with a tiny bit of fear/guilt-inducing.
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gmadorisylove Jan 2020
Hahahaha! Understood! Actually, I'd go to a seminar with any one of those titles, but maybe I'm weird that way!
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A priority topic should be "Care for the Caregiver:". Maybe incorporate this into each of the other topics as well. The old analogy of parents putting on their oxygen masks in a plane before putting on their children's works well here, though analogies of child care and senior care don't extend very far. They are quite different. In itself it may be a topic worth presenting. Most of your audience probably have experience in child care. Some people make the error of thinking they are similar. In most respects they aren't.

Wellness for caregivers is vital. Research indicates that up to 40% of caregivers die before the person they care for. That is a sobering figure.

Boundaries for caregivers is another good topic.

You will find ideas if you scroll through this site. Good luck
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gmadorisylove Jan 2020
Wow! Is that a current statistic? Where did you find that? Absolutely mind-blowing! Will definitely add your ideas to my list. Thank you for bringing this up!
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To golden's point about a priority topic, a preceding topic needs to be, "Do your parents expect you to be their caregiver? Do you want to be? Should you be? What if you don't want to be??" And, "What is caregiving? Who is a caregiver?"

Most of the time aging parents make an assumption about (or have a very vague notion of) the transition into needing more help from family/friends/neighbors. Caregiving is something that most people slide into by tiny increments. Before people know it, they are providing (or receiving) full-time care. They shouldn't do this, but it happens for all sorts of reasons (especially cultural and financial). Caregiving *is* a vital topic but attendees will absolutely NOT (yet) see the "priority" nature of it until they are informed of what's coming their way and why they should care and prepare. They need to internalize other info and facts before seeing how caregiving relates to their futures.

A thought: you can have one or two "guest" speakers to make your seminar points more real. Find people who have done it "wrong" and who did it "right" and have them describe their journeys. Make sure you don't come across as "promoting" a certain service or product (so need disclaimers stated).
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gmadorisylove Jan 2020
Guest speakers are absolutely part of the plan! And I agree 100% about making certain no products/services are endorsed or promoted.

You're so right! The decision to provide care needs to be intentional.
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I love your thoughtfulness! First of all, I want to say thank you for doing this.

As the only daughter who cared for my parents, I would like to say that I feel it is unfair for a daughter to do everything! Be fair with your children.

Don’t automatically expect children to be caregivers. It’s a huge responsibility with huge sacrifices as well.

Stop trying to force children in the family to have a relationship with one another if they aren’t compatible for valid reasons. That is selfish of the parent to want siblings to attend holiday dinners when they have been nothing but disrespectful.

Cooperate with your children. Stop making them plead and beg for things. It’s give and take. Give respect to receive it.

Make sure all legal forms are in order.

Respect that caregivers need respite.

These are just a few things. Not sure if I expressed my feelings well. It’s not easy being a caregiver. Not as simple as it may appear to be. I truly wasn’t as prepared as I should have been.

So thank you so very much for organizing this meeting. Wonderful idea and much needed!
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Two ideas I think should be mentioned are:

1. Boundaries, and why they are so important. Parents can make it difficult, and the caregiver must stand firm and enforce their boundaries, or they will be sucked in and under.

2. Dealing with hospital personnel who want to dump the care of the elder onto family members, when the person/family can no longer care for the elder. Make seminar attendees aware of the lies and promises that might be made by the hospital personnel ("There isn't anywhere available right now, but if you take him home I'll let you know as soon as I find something!"). The best time to have facility placement take place is often when the elder is hospitalized. If the hospital wants to release the elder who needs a lot of care, and the family can't/won't take responsibility, the key words to use by the family are, "This would be an unsafe discharge." That forces the hospital's hand, and they have to come up with another plan.
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onlyoneholly Jan 2020
Agree absolutely with your observation. To add to this, get a subject expert to overview "Help Response" companies like Life Alert. Know what they can or cannot do. Know what info they will expect to know from you and your LO. Their services often are used in tandem with a trip to the ER. I learned a lot. One example is a call from them that " your LO has fallen and has been transported to the hospital." The problem is that they said they could not tell me which hospital. A "HIPPA rule"? I had full legal authority and they had those documents. Find out what the policy is for a company you would consider hiring.
One more comment -- make a phone list of hospitals and EMT services in your LO area ahead of time, just in case you are blindsided by a call.
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I learned several very important things here that every adult child if an elder should know:

1. You can say "no" to hospital discharge. It can be because it will be an "unsafe discharge" because there will be no one at home to care for the patient, or because they haven't addressed the problem that the patient came in for.

2. UTIs can cause psychiatric symptoms in elderly people.

3. A good geriatric psychiatrist may be the most important person to get on your parents' care team. They see the who patient, body, soul and mind. Your parent should have to suffer with anxiety, depression or panic. Psychic pain is PAIN and should be treated. Even if it means a Black Box drug.

4. Don't give up your livelihood or your marriage to become caregiver to your parent. Your parents' funds are their to fund their own care. Your retirement funds will be needed to fund yours. Everyone pays their own way.

5. If you HAVE to move a parent in with you, make sure that YOU have POA and access to their funds to pay for care. Not your sibling or step-parent. Set up a caregiving contract and room and board agreement with your parent BEFORE they move in.
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My Mother passed away about a year ago from Alzheimer's-related complications. Here are five main topics that I found important throughout this whole Alzheimer's experience.
1) . There is no new learning that you can expect from this person any longer. I tried to "train" my mother to save up her mail so that we could go through it together every few days. Big surprise/ It didn't work.
2) . Figure out finances and obtain POA and Durable Medical POA if you are even thinking of taking over your loved one's life and affairs. It's incredibly difficult and stressful even WITH these documents in place; do not attempt managing your loved one's affairs without both of these items in place.
3) . Reality. Grip it. You will need to keep telling yourself that this formerly capable person is no longer capable of making sound decisions for major life choices; you will need to step in and step UP to make decisions for them and be their advocate. Even though they may disagree or not agree, with any or all of your decisions. As an RN, my primary duty to my patients in the operating room was to be their advocate since they could not protect or defend themselves. You will need to act on this truth, for their benefit; again, even when the loved one does not agree and cannot fully or even partially understand why you are making certain plans/events take place. Examples include hiring help inside the home, or placing your loved one in a memory care facility, or taking away the car keys.
4) Know who your support system is (and who is not helpful or supportive), and try your best to not take out your grief, anger, sorrow/angst on any one person for too long. You may lose friends/support/loved ones if you " take it out" on any one person for too long. I speak from multiple personal experiences on this one. Attend support groups formal therapy, and/or online support groups as often as you can in order to keep your existing support system in place, and you will hopefully add to your trusted core of true friends/family.
5) Don't ever forget to give yourself a break; a break from guilt , anger, discouragement, and disappointment. You will make mistakes along the way and second-guess yourself. We are only human and this is going to be one of the most difficult journeys on which you have ever taken; you didn't even ask for it, but it's happening! It might be long, it might be short, but it will be difficult; make sure to pace yourself along the way.
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If dealing with dementia any stresses can cause decline in cognition.

I found with Mom that she had a UTI and did not even know it, doc found it in a check up.

She also was on long term (months) antibiotic for eye surgery and had massive decline both mentally and physically. Shortly after we removed antibiotic she bounced right back!

Contact groups that can set up a table or speak, like elder law, geriatric medicine etc.
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disgustedtoo Jan 2020
UTIs are SO bizarre sometimes! When first joining in this forum, I read so many comments saying test for UTI and scoffed... until it happened to mom.

Round 1: Mom is in MC and is rather mild-mannered, easy going there, but suddenly (on a Friday evening of course, after doc office hours!) developed raging sun-downing. Mornings, ok, afternoons/evenings, out of control! She had to take anti-anxiety meds along with the antibiotics until the UTI cleared.

Round 2: Sudden onset of night-time bed wetting. Once UTI is treated, bed wetting stopped. Nurse is now aware of this and on top of it! Mom did start again with the bed wetting, so the nurse scheduled a test for UTI - yup.

Antibiotics CAN be a problem. My mother AND my daughter are allergic to the Mycins (found out when daughter was a baby and then mom revealed she also couldn't take them.) Brother was allergic to penicillin and/or the sulpha. ANY medication can cause issues, if a person is allergic - even worse when it isn't known! While in the hospital, they kept shooting me up with Heparin. I don't mind needles, but these were especially painful (back of arm or abdomen is the usual locations for these.) After they had to bandage the left arm, the right became black marbles, elbow to armpit... Meanwhile, hematologist came to discuss my platelets, which were normal on in-take and have shot sky high. Usually this would cause them to drop, not rise. Um, you are the doc, I am not allowed to eat, so it HAS to be something YOU people are doing! Last shot was taken in the abdomen, and I developed a hematoma! Needless to say, the Heparin shots stopped. I now list this as a allergen for me (it is possible dad was also allergic to some blood thinner - he was to take various meds forever after heart surgery and in the end he was down to baby aspirin.)

I relate my experience because I was not that old or demented. Imagine a person with dementia or a baby going through this - they might not have the where-withal to express any complaint or concern!
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After participating on this forum for a long time and going through almost every elder issue there is, what strikes me the most is how often the kids get just totally blind sided when the *#@)’#$ hits the fan. So a couple thoughts:

Have THE TALK early. Don’t wait till the neighbors are calling telling you about mom wandering the streets in her bathrobe. Sit down with you parents/loved ones and ask about end of life wishes, POA, Wills, bank accounts and so forth. Lay some track early.

Elders are not always cooperative. Well, hardly ever really. With my folks I had to do lots of covert operations to find important paperwork and financial info. And what I found was a big mess.

Dont wait for the official diagnosis of dementia to act. You see lots of posts here where elders supposedly don’t have dementia but are making horrible decisions. To avoid financial, driving, and medical disasters do as much as you can to mitigate.

DAD WILL GET SO MAD IF WE TAKE THE CAR/TAKEOVER HIS MONEY/GET IN HOME HELP etc, etc. You cannot allow poor decisions and/or dementia to run the show. Elders are going to have to make changes they don’t like. And it can be a battle. I learned to choose my battles. Didn’t win them all by a long shot.

I CANT LIE TO DAD......Yes you can. Fibbing is the only way to keep elders calm and help them as dementia develops. My folks would have died horrible deaths in a filthy house had I not done my daily theater.

Take advantage of the crisis. There will be a fall, stroke , car wreck, or any number of things that force a change. The change might be such things as ending the driving, getting in home help or moving to a care facility of some sort. My mom fell for the umpteenth time, went to the hospital and from there to assisted living. Huge fight, crying all that, but I held fast. No way that women was going back to that run down house. She was a two person assit at this point.

Realise that you can’t fix old age. We’re programmed from birth to do the best we possibly can for our kids and parents but you can’t fix everything. I read so many stories of folks chasing around for the right doc, right therapy, best drug, for their elders. I understand, I did some of that also. But at some point it really doesn’t matter that a 90 year with advanced dementia, COPD and heart failure eats a little too much ice cream or quits taking some drug or other.
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gdaughter Jan 2020
Agree...and then there would be the great presentation: what happens if you HAVE NOT had the talk...and the first/best steps to take ASAP! LOL
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I have arranged for the local Alzheimers Assoc to come give a talk, about 45 min to an hour, titled THE DIFFERENCE BETWEEN ALZHEIMERS AND DEMENTIA. Huge help to employees as well.
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I see a lot of great information here about the needed topics to discuss. I’m not sure where you are located, but if you are in the United States, there are programs and services available through the National Older Americans Act. These programs are offered by the State Agencies on Aging. There are Area Agency on Aging(AAA) that provide assessment/evaluation for older adults and caregivers that can help.
There are other great resources at your local Aging and Disability Resource Centers (ADRC), also available through your AAA. (Housing, repairs, legal, heat/electricity, respite, case management, homemaker companion, transportation)
As for other topics to touch base on:
*behaviors (not showering) (repetition) (agitation) etc...
*Dementia education: effects all of the senses. (Can see but the connection to the brain from the eyes is damaged)(peripheral vision is lost) (Can hear but can’t understand)
Dementia is a set of symptoms caused by 80+ diseases. Diagnosis is key to treatment.
i have seen that many children do not want to talk with their parents about aging issues. I have many seniors that want to discuss end of life issues and the kids will not hear of it.
Another issue is gun safety.
Just a couple of ideas to help.
Cuddos to you for offering this help to people. It is more than needed.
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I took a 12 week class given by my County Office of Aging. I suggest you contact your local Office of Aging, they may already have some ideas for you that would include speakers. For example, one session included an Elder Law Attorney talking about the legal aspects of caring for elderly parents, etc.
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Wonderful that you are planning to hold this program/series of events to your coworkers.

It is a wide field, so I think it depends on how many sessions there are, featuring a set of subjects each time, or having the colleagues each submit their questions or wishes ahead of time.

If it is a form of support, then have everyone have the peace to talk and share their challenges, and know they are not alone. Share one another's tips, warnings, successful experiences.

For homecare or assisted living, reaching out yo specialists could be useful, perhaps through the local Senior Center or Alzheimer's organization. Especially the Alzheimer's Association or similar organization must have many suggestions and guidance on what to address.

- Power of Attorney, Guardianship (Elder Law Attorney), Health Proxy: these are important topics I myself am still in an exhausting process of sorting and finding a proper attorney for.

- Learning how to stay up in spirits and not to feel overwhelmed caring and dealing with the loved one's anger, agitation, violence.

- Memory clinics or general tips like puzzles, concerts, card games, coloring books. For my case, music with participation has been overall one of the best things. Gives them a fun challenge with participation and joy of music. Really works the brain.

...I think there are just so many topics to list, I'll stop here. Again, such a broad topic, so again I suggest you have colleagues submit what they need addressed.

Beat of luck, and hope you have enthusiastic guest speakers (or who give you the info to share at least), and attendees who will benefit.

This is so good of you to want to help others, which would be so helpful for more work places to do.

Kesp us up to date! Thanks.
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I have a few ideas for topics for you.
1. Someone from a Veterans Assistance Commission office to come in and explain some of the programs that are available to Veterans and the family.
2. An Elder Care Attorney to explain some of the processes that might be necessary. From Guardianship to Avoiding Guardianship, Trusts, Wills and all the rest of the stuff that no one wants to talk about.
3. Someone from Hospice. They can explain how much help that Hospice can provide, that it is not a "6 months or less" and that they will not "overdose and kill" your loved one.
4. Someone from the Alzheimer's Association that can hep explain dementia. They have a WONDERFUL program that takes a few weeks but it is so full of information. And include other groups. Parkinson's has a particular dementia, each dementia has it's quirks that people should know about.
5. Ask other employees to share their experiences, what they have learned navigating the quagmire that is care-giving. There will always be someone where you were 6 months ago and someone where you will be in 6 months. When I first started going to support groups I felt that it was a good day if someone was having a more difficult time than I was...and if I could help someone with what I had learned that was worth the education. We all learn from each other
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gaknitter Jan 2020
I would include a pre-need counselor from trusted local funeral home, not the pushy kind. There are at least 50 decisions that have to be made at time of death if no pre-need is in place. I had a pre-need policy for my mother. It took off such a burden at the time of her passing. She had been living with us for 9 months. You all know how difficult that was. Having the pre-need in place and all decisions made with her 9 months prior made a huge difference. It may not be an easy conversation but it's a very necessary one. I was only child, but I have heard of families almost coming to blows in arrangements conference, even local PD called, so getting things settled according to LO's wishes and preferences certainly saves arguments (or should!) You are very thoughtful to do this. I live in a 55+ neighborhood and am checking into getting an elder care lawyer, and Medicare specialist to come to a neighborhood luncheon to provide information and answer questions. I may add VA if I can find someone because we have several veterans. Good luck and let us know how it works out and how your efforts are received.
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It might be best to have "experts" in the field come share. People who come to mind are "elder care/law" lawyer, representative from a larger/national bank that handles family trusts..., representative from a larger memory care facility, representative from larger home health care agency, and a doctor or nurse practioner who specializes in geriatrics. If your city/county has an agency on aging, ask for a representative to come speak as well.
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You have a wealth of information already in the responses you have received. I cannot add to them, as any specifics would be repetitive.

For what it's worth, I look at being a health care provider as a small business. You need to be assured of the quality and availability of help; don't do this alone! You need to be assured of your financial ability to carry out the responsibility; as you go forward your finances will be tested. You need to have backup that you can call on to replace you temporarily so that you can take a respite from the daily tasks. And probably most of all, you need a desire to do this service and follow it through, to face the unexpected and change the operations accordingly. You need a cheering section, spiritual support, or whatever it takes to keep you positive about the task.

I hope your idea of an after-hours seminar works out. I think you have a good idea and will be able to set it up and encourage people to participate.
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Outside speakers and local experts are a great idea. Poll the group to identify their most pressing questions ahead of time, then you'll know which speaker to invite first. Be sure to inform the speakers that a sales pitch is not what you want and to prepare for an open and honest discussion. Take turns bringing some light refreshments and you will have the start of a support group among your coworkers.
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Bless you for your efforts..and know that EVEN at an office on aging, where I have worked 25+ years...aging happens to EVERYone, is inescapable, and is regrettably true: not for "sissies" (though I prefer "weak of heart". There is so much to cover so I will shoot a few suggestions out before I am late for work...Funds for programs come in through a system and every area has a local area agency on aging. Our own puts out a great little guide (though it also has to be taken with a grain of salt as anything does with advertising...that is, there are more resources than those that advertise and the ones that do should never be considered as endorsed). Do call and find out whose your is, (google elder care locator), and I bet they'd be happy to get a load of the guides to you, or at least one and your other attendees can order their own individual copies. You want to be sure to provide the long term care ombudsmans office number and to cover the links to reviewing nursing home and other facilities. For sure find the best CERTIFIED elder law attorney firm. We are lucky to have one who cares about educating people and in addition does so on a per task fee. Those that charge by the hour...beware. My lesson from that was that they can and will charge for any email communication you have however trite to "read, review and respond" in 1/4 hour increments that will tally up faster than you can say "living will." But you do want to include all the essential paperwork needs. The firms in private hire will bang your door down for the opportunity to fresh blood like starving bedbugs. I can tell you that some of the best reputation firms can wind up treating you like crap, and no matter which firm you go with, they want your business and won't tell you the shady past of an employee if there is one. IT all comes down to who you're trusting to let in the house. MAKE SURE THEY DO A BCI/FBI background check and demand proof. Still lock up valuables, remove checkbooks, credit cards. They will be very nice. They always are. Don't trust anyone as much as you want to. Only those that accept medicare are REQUIRED to do the background check. Hiring privately is a challenge...get a tax accountant type in to explain how to keep records and what to do/how to do it. A banking person might be good on steps to take to be able to access their accounts. And, especially, never forget to look right under your nose: if you are lucky there may be a local office on aging that can be a resource and provide services from locating home delivered meals, shopping, house cleaning, transportation. All people have to do is call their local mayor or city hall to learn if it exists. There also are probably some great books to help...one might be Working Daughter though I have not personally checked it out. Curadux is a great company when facing very tough and complex medical decisions. HDIS is a great home delivery company for incontinence supplies. Support groups can be a good or bad thing (maybe you can set one up at work or be a site?) but I have found it dependent on who attends and the leadership, if professional or lay/volunteer.
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I know you mean the very best, but I would be concerned about some of these issues being divisive.  Nothing wrong with advising to get DPOA, etc. but in my office we are very cautious about discussing money.  The people whose parents get Veterans Aid may be resented by the ones who do not (and fyi, I my LO gets VA, and I think she earned it, but I do not lord it over others). 

In addition, there may be employees whose parents are not here legally and may not be entitled to Medicaid/Medicare.   This can be a very sensitive subject. 

I wish you and your firm the best.
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I found that an elder care lawyer versed in medicaid rules extremely important. They can protect assets that otherwise would have to be spent down due to the 5 year look-back requirement and/or penalty phase. Moving assets before the 5 year look-back via gifting or using irrevocable trusts matters greatly if one is less than wealthy and wants to preserve assets for heirs.
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My "2 cents" worth of suggestions is from the perspective of a caregiver for my mom who had Alzheimer's. I'd suggest to people not to correct the Alzheimer's patient, as long as this deception doesn't harm anyone. For example, my mom envisioned that the woman next door invited her over for coffee, (as I'm sure happened when I was growing up many moons ago, and in a different city),but not now, since the neighbors next door, where she was pointing, had moved, and no one had bought the house yet). My mom got agitated and aggravated when I pointed this out to her, so I figured if she envisions this, then fine. I had worked part time when my mom moved in with us, and Hubby's schedule allowed him to look after her while I was teaching. Sometimes he'd call to say that he was following my mom down the street (in the neighborhood), and she couldn't be reasoned with, so I told him to tell her that a friend was going to be calling her in 10 minutes, so she'd really need to get back home. She usually complied. Ten minutes later, she had forgotten all about the supposed phone call. I wrote a book about our travails called, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale," I mention "phone-y" episodes like this. I'd include in your presentations to your co-workers, that you often have to join their concept of reality, because they can't join yours (any more). I'd also echo what others have written here, about encouraging people to speak with a lawyer who specializes in eldercare issues, contact a local Area on Aging for some direction, etc.
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disgustedtoo Jan 2020
You have to LOVE those who say no no no no, do not lie to the LO!!!

Sure, torture my mother over and over telling her that her mother passed ~40 years ago! Even more recently she brought up her younger sister (all in her generation on both sides have passed on, some in mine too!) She summed it up with 'She must be busy with that baby.' She would be referring to my cousin's second child - both had a form of MD, but the second one was dependent on all care. That "baby" would be close to 40 by now!

Even if the issue isn't related to other relatives, any way to soothe them while 'living' in their reality is what it takes. You can't argue with them. You can't convince them. If safety issues arise, it is more critical to have skills to circumvent what they might be doing. That was a great idea about the phone call! She would likely react to that and scurry home, but of course in short order forget about it! Distractions. Refocus them on something they CAN relate to, get their mind off whatever they were fixated on. My nose hasn't grown yet!!!
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I do think your final workshop should be "What to do so your children don't need these workshops". Seriously. We need to plan for ourselves and take the necessary steps so our children do not need plan and worry. Aging in place? Remodel that house and make financial plans for outside help, not your children. Anything they do should be icing on the cake. Expect you will need more help? Move to an independent living section of a community with memory and personal care sections. Make a living will and sign a POLST, appoint a medical POA - make sure they know your wishes and will agree to carry them out. Appoint a financial POA. Use an elder lawyer to help set up a way for your POAs to overcome any problems that may come up ( just read the posts on this site for those!).
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disgustedtoo Jan 2020
Agreed, but also even more important for those who have no children! I have been planning to set this all up since the issue came up with mom (help her get set up when dad was failing, revisited when dementia was creeping in.) A combination of having SO much on my plate (dealing with everything for mom, getting her condo cleaned up and sold, working FT part of that time, getting caught between 2 houses myself when laid off, and lack of funds) has delayed this, but I have had some discussion with the kids. I did tell them NOT to feel guilty if I end up like mom and they can't handle visiting. I am hoping this financial crunch is just about done and plan to get all my stuff in order! At the least I will review everything with them, if they can't join me, but they should and get THEIR act together! My house needs to have repairs finished, and I planned then to sort/clear out my unnecessary crap and didn't OB bring ALL the crap from mom's place to mine! MORE crap to deal with!!! SOON!!!!
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Although the focus here seems to be on dementia, there are MANY reasons why a LO (NOT just parents) might need help from others. It would be good to start with covering what one might encounter as LOs age or have medical issues and what might be good to set up before the emergency happens! In my case, it is dementia in mom, but other thoughts have occurred to me, mostly from following others' questions/comments.

From there, each seminar should cover one topic, such as those suggested (Medicare, Medicaid, Elder Care atty, options for care, setting aside funds just in case, other benefits such as VA.)

Dementia covers so many different conditions and each has its own course, so this may need multiple seminars - start with overview and what to watch for. In retrospect, there were some very subtle signs for our mother that were missed. It was repetition during phone calls that got me investigating online. Bros were not totally on board.

Have another session also for dealing with resistant/difficult family members! There are so many on this forum who have BIG issues with family!

Another segment dealing with guilt, boundaries and "Reality." Some feel guilt, can't draw the lines needed, etc. How to respond when their reality is out of touch (thinking LOs are still alive, seeing, hearing or imagining things, unfounded fears.) Some insist we tell the truth - fine if someone is okay cognitively. I don't see the point in upsetting mom every time she brings up someone long gone! She won't remember and will just suffer every time. It IS okay to fib a little, when necessary.

Another difficult topic is getting the LO to move when it is time. Mom's plans included AL at some point, until dementia took over. I found this site because she refused ANY move and EC atty told us we couldn't force her, despite having DPOA (many here think this allows you to do this! It doesn't.)

Having an expert in the topic covered present at these seminars would be great! I might also suggest, if possible, the attendees bring their LOs (at the least have handouts that can be shared later.)

There are so many on both sides of these issues who are resistant. Parents who don't want to set things up (fear someone will take over, don't think it is needed, etc.) Family members either in denial and/or critical/resistant to everything that is sensible. Resources for how to deal with those resistant would be nice to have. In our case, mom was having a hard time trying to care for dad. He wasn't out of it or needing excessive care, but still. She many times mentioned an EC atty, so I took the name, looked him up and called. He was then only doing seminars to teach others, but they referred me to another. We used them to help mom & dad. It was helpful for me later. Doing lookup on dementia filled in the gaps, over time.

We should be aware, on some level, of what our LOs conditions might be, what medications they take, etc, as well as discussing financials, final wishes, etc.  Many are resistant to "give up" this info, but it doesn't need to be detailed. At the very least, know what banks (mom had account at a bank with SS funds and others at a CU), what insurance do they have, is there life and/or LTC insurance policies. IF possible, help them organize everything, for access if/when needed. When they are still lucid, but resistant, explain it simply: IF something happens to you, such as accident or severe illness, how will we care for you? Dementia does NOT have to come up, but it can't hurt if it hasn't happened yet. We never mentioned the word to mom, as to her it meant you were crazy, which isn't true. WE all need to do this ourselves as we don't know what the future holds for us. IF possible, encourage the LOs to join you when you set up your own Will, POAs, etc. This might help convince them it is a good thing to do!
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disgustedtoo Jan 2020
Likely would run out of characters to touch on the SS, driving and other subjects, so here it is:

In general ANY federal entity does NOT honor ANY kind of POA. Because mom already had dementia and we moved her, in order to change her address (for documents, etc, which cannot be forwarded by Postal Service), I had to sign up as SS Rep Payee. Many say if you have access to their account, this isn't needed. On non-legal level, no, but if you check into this, SS DOES require it. It may never become an issue, but they consider these funds THAT person's and unless you are Rep Payee, you have NO legal business touching it. It was for me a simple process: call local office, set up appt, answer questions they ask and wait for approval. The difficult part was setting up the special acct needed, but that was the CU problem. They do require yearly accounting, which can be done online. Keep good records on how the SS funds were spent, no big deal. For mom it was simple: SS and pension cover SOME of her facility charge, trust fund covers the rest and any other expenses, so I only have to report that ALL SS funds were used for food/rent.

Side note: her bank and CU had no issue with the DPOA. Some people report banks won't honor the DPOA. If that were the case, I would get the EC atty on their case! Most billing was also simple to change the billing (not service) address. The only exception was her Credit Card. They allowed SOME activities (phone query, cancel card, freeze or close account) but would NOT allow me online access. I even requested THEY set up alerts, so I would know when to check by phone, but they denied that as well. At the time we set up DPOA, it likely wasn't an issue, but I believe it can be written up to give "electronic" access - whether they comply or not is the question. They can deny, because if you ever read the disclosures, only the "owner" of the account can create online accounts (applies to CCs and SS, probably others as well.)

In mom's case, the pension was dad's federal pension - this was even more difficult to do, but once completed they have allowed her funds to go to the same CU acct and I manage it from there.

Setting up the trust was also fairly easy with the EC atty. It has served us VERY well! That said, I learned something new this year. SS does a 2 year look back and they consider the trust funds being deposited to cover her facility as INCOME and therefore are charging her MORE for Medicare. WTH? I even said to the woman that this wouldn't be an issue if we'd left the money in her account!! It ISN'T really income - not all of it. Any investment return, sure, but MOST of the money there was HERs! This is more a warning to others, so they are not blindsided.
Another side note: IF possible, work with LOs in clearing out junk and unneeded items and help with cleaning! Some are semi or full hoarders, or resist help, so this may pose problems. Worst case is you get stuck clearing it all out later. We had that happen - it took over 1.5 years to clean/clear/repair the condo to sell it.

Forgot to touch on driving in the first post - this IS a very touchy issue. Would be great if the states all had a common rule about it and made it easier for us to cross this hurdle! Many say take the car/keys away. Others say we can't, it isn't legal. Some states require doctor to report, but many docs don't want to get involved. Mom's state at the time required self-reporting! What person is going to tell the DMV they have dementia and need to stop driving??? We were able to take the keys, then the car, with just flak from mom about it. She didn't have the capability to consider reporting it stolen!

Consider VERY carefully before attempting to care for a LO in their home or yours. What may seem easy enough at the onset could become overwhelming! If you get paid, be sure to have a legal contract stating duties and pay rate(s).
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The one issue I would suggest is "WHEN IS Enough, enough? " There comes a time when that line in the sand needs to be drawn. Have that talk before the tide
comes in.
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SNeedsAVacation Jan 2020
Yes ! Along with when to say no.
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Lots of good ideas here. One thing I would add is making the individual's or family's wishes known, and on file at the hospital. The last time Grandma was in, the nurses asked her if she wanted a Do Not Resuscitate Order. She didn't understand what that meant until the nurse finally said, "If your heart stops do you want to go meet god?" If LO ends up on life support, what is their wish?

Also, like somebody already mentioned, find out what LO's final wishes are. Do they want a funeral, celebration of life, normal burial, natural burial, at home funeral, cremation etc. How much can the family afford for a funeral? Maybe bring somebody in from a funeral home.

Interesting youtube channel to check out, Ask a Mortician. Caitlin Doughty is a mortician and has videos up about all sorts of things. Low cost alternatives to a traditional funeral, what the family can request and how to become more involved, what happens to the body, etc. She has interesting videos about various topics, including historical subjects.

Here's a video talking about death denial and overcoming it.
https://www.youtube.com/watch?v=0WOyFErcTHU

Also, a big one we've run into, get somebody in from the VA that can explain the types of benefits, what you need to get them, and what paperwork to fill out. It's pages of paperwork and the paperwork is different depending on who is applying for benefits.

Other topics:

How to get the car keys away from a family member who should not longer be driving.
Getting your loved one to the doctor, grocery shopping, errands etc.
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Read this fantastic book:
Atul Gwande's "Being Mortal - Illness, Medicine, and What Matters in the End"

As a health professional, the beautiful gems, the gold nuggets, that this wonderful author offered up, have helped me to deal with the challenges of supporting my own elderly parents, and come to terms with some of the tough decisions. I also give the book to my patients' families - the feedback I get is always positive.

This is a deeply moving book, by an internationally acclaimed author who is a physician and surgeon, who describes his own personal journey, and insights from his work with families on their journeys.
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Ay lawyer office will gladly come to your work and give a talk about financial topics, including VA benefits, Medicare and long term care. I recommend creating a series. Different law offices to talk on different topics, once a month.
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The benefits of Yoga( slow, pose holding) and balance moves, especially as we get older and are working in an office. A short demo/interactive on some chair yoga to use at the office( a couple of stretches each hour) and basic balance one can do while watching the coffee brew and copies copy. I believe the key to people doing continuously is incorporating into their lives in small ways. Taking small moments of time for ourselves makes care giving for our parents a bit less taxing.
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