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Reader Question: My mom is ninety-two years old. She weighs 62 lbs and has been diagnosed with dementia. She doesn’t want to eat. What can I do? How do I deal with this trauma of dementia and weight loss!

First, let me begin by offering a virtual hug. I can feel your sadness through the keyboard, and you are certainly not alone. Let me say, you are brave, you are allowed to feel sad, and you are doing an amazing job by taking the time to educate yourself.

I have seen many adult children heartbroken over the changes their loved one’s experience during a dementia journey. There is no easy way to navigate the mental and physical changes your mom is experiencing. But, I will do my best to offer some advice that might help a bit.

Dementia and weight loss

Before the changes in speech and the obvious lapses in memory, one of the first sneaky signs of dementia is changing weight. Weight loss can be the result of many things including positive lifestyle changes and illness.

But, when weight loss is dramatic or continues over a long period of time unintentionally, it may deserve a closer look. As dementia progresses body composition may continue to change.

When a person is diagnosed with dementia it is very important to monitor both fluid and food intake.

Why does dementia affect weight loss?

Dementia is an umbrella term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life.

The most common cause of dementia is Alzheimer’s. But, other conditions may contribute to dementia including Parkinson’s and Stroke.

The point is, dementia may be a cognitive condition, but it affects the whole body. There may be several reasons a loved one experiences unintended weight loss.

Loss of interest in food

As a care provider I have spent considerable time with senior adults talking about food and meal planning. For those struggling with dementia and weight loss, there is often a disconnect between the feeling of hunger and the actions required to meet that need. As people age, they may experience a loss of taste making food less appealing.

I can’t tell you the number of times I have seen a person with dementia say no to food only to clean the plate once placed in front of her.

Helpful tip: offer prepared food that is appetizing and in line with your loved one’s tastes. Make sure to show the food and make it easy to eat and enjoy.

Inability to process food

Sometimes weight loss occurs because the body become less efficient in processing food. It is important to have your loved one seen by a medical professional if you notice rapid or persistent unintended weight loss. There may be an underlying issue that needs to be addressed.

Helpful tip: track your loved one’s weight. And keep good notes on food intake. Regularly share this information with your chosen medical professional.

Confusion on how to eat

As dementia progresses, one simple task become complex series of activities. Even using a fork or managing coordination from plate to mouth becomes impossible. Make sure your loved one isn’t giving up on food out of frustration or fear.

Inability to recognize food happens to some people with dementia. I remember my grandfather helping himself to a huge serving of potpourri before a family member recognized this nonfood item on his plate. The same confusion can happen with once loved food items.

Helpful tip: Don’t crowd a plate and keep items separated. Use solid patterned plates that help the food items to stand out. Think how confusing a flower printed plate could be to someone with dementia and reduced vision.

Focus on foods your loved one will eat now! Maybe mom hated mashed potatoes a decade ago, but if she likes them now -roll with it!

Anxiety

It is terrifying to feel lost while performing a task you know you should be able to do! Offer encouragement and create an environment that is comfortable.

Sometimes, a person is cognitively aware that he cannot self feed and may feel embarrassed. Be sensitive to a loved one’s pride and look for ways to support independence while meeting physical needs.

Helpful tip: watch to see if your loved one struggles with the activity of eating. Simple changes like offering a fork with a larger easy grip handle can make big changes in your loved one’s ability to eat.

Prepare foods that are easier to move from plate to mouth. Be creative and supportive. Make happy mealtimes the goal and let go of expectations for mealtime norms.

Physical Limitations

Changes in physical ability make it harder to access food. A person who was once a whiz in the kitchen may feel to tired or overwhelmed to prepare meals. Make sure your loved one still has access to the food he or she needs.

You would be surprised at how many seniors stopped eating regularly because it is too hard to cook, reach shelves, and go to the store.

Helpful tip: reorganize food and food related chores to meet your loved one’s needs. Sometimes, adults facing dementia and weight loss do not realize they have stopped cooking or eating regularly. It is important to create routines. And, offer ways to compensate when physical limitations in the kitchen get in the way of meal times.

Depression and Loss of routine

Dementia can make people feel restless and agitated. They often loose a sense of routine and structure. There are many changes going on and food can seem like a lost priority.

Helpful tip: maintain routines and help keep things interesting. Try planning engaging outings and make sure to include regular feedings.

I once had a client who would make herself toast and butter with a cup of coffee each morning when the coffee timer beeped. A well-meaning family member switched out the old coffee pot with and easier to use new model.

Unfortunately, when the coffee pot beeper left so did the coffee and toast routine. People with dementia create alternate pathways to routine and memory. Try to protect those rituals and create new ones with very simple regular cues.

dementia and weight loss may often coexist but you can make small adjustment to a persons daily routines to support better nutrition. If you need more support and you live in Southern California you can contact us. Otherwise, we recommend you work with a private Care Manager.

These professionals are usually nurses or social workers and they can help you develop routines, tools, and plans to make meal times more pleasant for everyone.

 


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August 23, 2019 Senior Living0

Elder scams are on the rise. 

Nobody expects a scam to happen to them until it does.

But it’s happening.

The elderly are scammed to the tune of $37 billion each year according to Bloomberg.

So what should you do when you find out your elderly loved one is being scammed?

In today’s post, I’ll share some tips on how to salvage such a situation.

Elder Scams: the signs to look out for

But first, how do you tell if something is a scam or not?

  • Your elderly loved one tells you they received a call or letter from a government agency asking them to verify personal information. Usually, these types of scammers will call and say they are from the Internal Revenue Service (IRS) or will erroneously say they are calling from the “Tax Department”. Once, they get personal information, that can use to it drain bank accounts and do whatever else they wish.

 

  • You elderly loved one says they received a call or letter telling them they’ve won some kind of lottery or sweepstakes and that the company needs a credit card so they can “save their spot”.

 

  • If you cannot find any information online about the company that is making calls or sending letters, there is a chance they are scammers.

 

  • More tech-savvy scammers will send e-mails with the logo of a legitimate organization such as a bank and ask for the other person to click on a link to verify something. A scammer once sent me an email with the logo of a bank I use asking me to verify some details. I almost clicked through until I decided to check the email address it had come from. It was not the usual one I got from the bank so I stopped and then called the company to make sure they really wanted this information from me. Turns out they did not need that information. Had I clicked on the link in the email, I could have been defrauded.

And while these are good rules of thumb to follow, scammers do get savvier with their techniques each year.

A combination of keeping your guard up and not falling for anything that is too good to be true is a key to preventing scams.

What should you do?

Scammers got your loved one, what should you do?

Report elder scams

First of all, it is likely that your elderly loved one wouldn’t want to tell you that they were scammed. In fact, according to the FBI, older Americans are less likely to report a scam.

However, reporting it can help to retrieve their money.

It will also put an end to this activity so that other seniors don’t suffer.

If you know the person who has scammed your loved one, it is your responsibility to call the FBI and report them.

Call the financial institution involved

If the scammers stole money, the financial institution will more than likely refund the money following their own investigations.

Help your loved one understand elder scams

Help your elderly loved one by educating about elder scams.

Tell them about the warning signs.

Send them this post to read!

Preventing a scam is better than salvaging it.

However, if they have this information after the first time, you will reduce the likelihood that this happens again.

Get a fiduciary

If you live far away from your loved one but you need someone to help them manage their money properly, you could hire a fiduciary.

A fiduciary will make sure to pay the bills, manage investments and other financial assets.

This should put your mind at ease that someone will take your loved one’s hard-earned money.

To learn more about what a fiduciary does, READ THIS POST.

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What is a power of attorney?

And do you need one?

If you are elderly, or if you have an elderly loved one, you need a power of attorney.

In today’s post, we will go over what it is, how it comes in handy and how to create one.

Let’s get into it.

What is a power of attorney?

A power of attorney is a document that allows you to appoint a person or an organization to handle your affairs on your behalf should you become unavailable or unable to.

Some scenarios that would require you to have this document include:

  • Falling sick and becoming unconscious and so you’re no longer able to make your own decisions.
  • Traveling outside the country and then you have an important decision that needs to be taken on your behalf immediately.
  • You suffer a mental health condition that makes you incapable of such decisions. Examples include dementia or Alzheimer’s Disease.

And these are just three examples. Essentially, any situation that would make you unable to make your own decisions requires this legal document.

Why you need one

You need one because it is best if the decision taken concerning you, comes directly from you.

When you have this as a legal document, it will reduce uncertainty on what you want.

Many family feuds have come about as a result of having no appointed people to take crucial decisions.

Sometimes, these issues are followed up in court and costs everyone involved precious time and money.

How to create a power of attorney

Like I mentioned above, a power of attorney is a legal document.

Thus, it is in your best interest to consult with a lawyer when you decide to create one.

There are different types of the document.

For instance, you could have a general power of attorney. With this type, you give powers to an individual or organization to take decisions that include:

  • the sale of your property
  • managing your financial affairs
  • buying health insurance
  • employing professionals

A healthcare power of attorney, will be able to take medical decisions on your behalf. Such a person or organization can be included in your estate plan.

With a special power of attorney, you will afford the person you choose with the exact decision they are allowed to take for you. For instance, you might designate one of your children as the person who decides what happens to a piece of real estate while another one will be responsible for something else.

I highly recommend that you talk to a lawyer about this as well as creating a complete estate plan.

It comes down to trust

You should never let anyone force you into making them a power of attorney.

If you don’t trust the person or organization, you are not compelled to give them this responsibility.

And because you can do this with a lawyer at any point in time, you can do it privately before you ever disclose whom you’ve appointed.

 

Whichever way you choose to go, it is helpful to have a power of attorney for those seasons of life when you are unable to take crucial decisions that have lasting consequences.

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Learning a new skill is a great way to keep one’s memory active.

This is because when you learn, you are training your brain to think in a different way than it is normally used to.

In a recent post on the blog, I talked about the various ways you can encourage your loved one to stay active.

One of those ways was to encourage your elderly loved one to pick and learn a new skill.

After I wrote that post, I figured I would dedicate a whole post to sharing a list of skills anyone can pick up and learn at any age.

So here are 20 new skills your elderly loved one can pick up and learn in 2019. Hey, you might even benefit from this list yourself!

Learn new skills: 21 skills seniors can learn in 2019

  1. Writing- think novels, screenplays and poetry!
  2. Photography- with our cellphones having cameras that are more powerful than the most expensive cameras 50 years ago, this is an easy skill to start learning.
  3. Photo/video editing
  4. Film-making
  5. Quilt-making
  6. Dress-making
  7. Knitting
  8. Pottery
  9. Painting
  10. Coding
  11. Blogging
  12. A musical instrument
  13. A sport – Surfing, soccer, volleyball, swimming, golf are all great sports to learn if you never learned them before. Make sure to get the green light from the doctor before signing up for physically strenuous sports.
  14. Acting
  15. A new language- We live in a largely international world now. Speaking another language is a great way to learn about the world.
  16. Computer skills- this would include things like using the internet or using Microsoft Word and Excel
  17. Cooking
  18. Entrepreneurship- Nobody is ever too old to start a business.
  19. Gardening
  20. Public speaking- Older people have tons of life experience to share with audiences. A local Toastmasters meeting is a good place to get started with learning how to speak publicly.
  21. Dancing

The advantages of learning a new skill

I already mentioned how learning a new skill helps with keeping a person mentally sharp. This is true whether you are a caregiver or you are reading this for your elderly loved one.

Here are some other advantages of learning a new skill you may have not considered.

  1. If learning the new skill involves going to a class at least once a week, this could be helpful in getting your elderly loved one socially active. A lot of elders cite loneliness as a problem especially when all their children, grandchildren and other family members live far away from them. In short, learning fights loneliness.
  2. Learning a new thing can be fun! When we are genuinely having fun, there is a lesser risk for mental health issues.
  3. If learning a new skill involves exercise, you should know that exercise releases endorphins. Endorphins interact with your brain cells to give you a sense of well-being.
  4. Learning improves memory.
  5. Learning a new skill fights boredom.
  6. When you become equipped with a new skill, it makes you a more interesting person.

Closing Thoughts

Learning a new skill is a great way to stay active regardless of age.

For seniors, learning is a wonderful way to stave off boredom, depression, loneliness and memory problems.

In this post, I shared 21 skills seniors can learn in 2019 to stay active.

And as a matter of fact, you don’t have to wait until next year; you can start right now.

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June 8, 2018 Senior Living0

You know you should have advance directives drafted as part of your estate plan, but what do they address?

Learn why they are essential essential estate documents and what protections they provide.

What is an advance directive?

According to the National Library of Medicine, an advance directive is a legal document that outlines your decisions about end-of-life care ahead of time.

An advance directive allows you to to tell your family, friends, caregivers and healthcare providers exactly what you want when you cannot make your own healthcare decisions.

In fact, there is research that shows that people who document their end-of-life care in an advance directive are more likely to receive the kind of care they want at the end of their life than people who don’t.

When should you think about advance directives?

Advance directives are not for aging adults only.

The truth is that a medical crisis can hit at any age.

Thus, you can draft an advance directive at any point in your life and you most certainly have permission to change it around as you please.

However, since this blog focuses on the elderly and helping them live their best lives, a lot of the information here will pertain to that.

Decisions that could require advance directives

Decisions that require an advance directive come up when emergency healthcare decisions to keep you alive come up.

These would include:

  • The use of CPR (cardiopulmonary resuscitation).  If you stop breathing suddenly or you are found with a low or irregular pulse, you may receive CPR. During CPR, emergency technicians and other healthcare professionals will have to push repeatedly on your chest to get your heart beating again. A side effect of CPR include broken ribs. CPR is also usually less effective in older adults who have multiple health conditions.

 

  • The use of feeding machines which will deliver nutrition to your stomach mechanically when you are in an unconscious state.

 

  • Ventilator (life machine) use to help you breathe while unconscious. A tube is connected from the life machine to the patient down the throat and into the trachea. Because this is uncomfortable, the patient will be sedated with medicine. If a patient is going to be kept on a ventilator for a long time, a tracheotomy will have to be performed. During this procedure, doctors will create a small hole in the neck and into your trachea (breathing tube).

 

  • Comfort care during end of life. Comfort care is anything you would like done to relieve discomfort during end-of-life care. This includes administering pain medicine.

 

  • Organ or tissue donation. You can draft an advance directive that communicates what you want to happen to your organs after you die. People with peculiar conditions have sometimes donated their organs to research to advance the quest to find effective treatments.

How to draft advance directives (and what should be in them)

First, talk with your doctor

Now let’s talk about how you draft an advance directive.

The first step is to think about what kind of care you would like to receive in an emergency medical situation.

I advice that you have this conversation with your doctor and another loved one present. This will ensure that you understand the underlying medical reasons for your advance directive.

Medicare or your private health insurance may cover advance directive planning appointments like this.

During this chat with your doctor, your medical history as well as your family medical history will help in the decision-making process.

Consider what is important to you

During your advance directive planning, it is also important to consider your values and what is important to you.

Perhaps during a medical emergency it would mean a lot to you to kept alive as medically possible because you want to attend a grandchild’s wedding.

Or perhaps you would like to take a picture with your great-grandchild before it’s all said and done.

You are absolutely allowed to include this in your planning process.

As a caregiver or loved one, it is important that you listen

The truth is that none of us like to think about death.

Planning for it is even more uncomfortable for a lot of people.

As a caregiver or the loved one of an elderly person, while the conversation surrounding advance directives is uncomfortable, I encourage you to listen.

Don’t become critical or think that end-of-life care talk will somehow hasten the death of your loved one.

Paying attention to their wishes communicates that you care about a subject your loved one cares about and will help them draft an advance directive they are happy with.

Once the discussions are done, put everything in writing

Time to write everything down.

And as a matter of fact, an advance directive comprises of a few documents.

  • A living will
  • A durable power of attorney
  • Other advance care planning documents

A living will is the document where you communicate your choices and preferences concerning healthcare decisions if you are unable to make them.

A durable power of attorney is the legal document where you declare who your healthcare proxy is. A healthcare proxy is a person makes healthcare decisions on your behalf. You can declare a healthcare proxy in addition to or instead of your living will.

Other advance care planning documents could include anything from the decision to not resuscitate (DNR) in particular instances versus others.

A lawyer can help you create these documents but it is not necessary.

Some states have their own advance care planning documents you can download and fill out.

You can also use the Eldercare Locator website- this is a government website- or call their number at 1-800-677-1116 to help you locate advance care planning services in your locality.

It is best to have this document witnessed and stamped by a notary public for extra authenticity.

The advance directive should then be kept in a safe place.

Don’t forget to let a trusted friend or loved one (possibly your healthcare proxy) know where you have your advance directive kept.

Closing Thoughts

Talking about death is uncomfortable.

However setting up an advance directive that spells out your wishes for end-of-life care will avoid confusion and conflict later on.

If you found this post helpful, please consider sharing it with someone else.


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February 7, 2018 Senior Living0

The cost of home care can vary widely depending on regional laws and wages, company policies, and the level of care required by a client. A few factors like how many daily hours, required experience and skill level, and support services offered can impact the final cost of care.

Factors that Influence the Cost of Home Care

Often companies charge a premium for shorter shifts. They may require a minimum of four hours to provide a care professional. Companies often use the additional revenue to entice quality care professionals to accept fewer hours in a day. A willingness to include more daily hours spread over fewer days my help save money in the overall cost by reducing the hourly rate. Shifts requiring overtime also impact the cost of care. Clients can potentially choose to reduce home care rates by splitting 24 hour shifts into eight or twelve hour rotations.

One of the first steps a home care company undertakes is learning about a client’s care needs. It is the company’s job to ensure client needs are met by an experienced care professional. During the discovery process, a home care company will ask about tasks a care professional is expected to fulfill. A client who requires transfers, round the clock toileting, medication reminders, and complete food assistance may be charged a higher rate. That level of care may require a professional with specialized training and experience.

Different Types of Home Care Companies

There are several different types of home care companies providing service. Some act as placement agencies, and offer very little oversight or guidance. They often screen potential care professionals, and may run or offer background-checking services. They range from large data bases, families can comb through, to local domestic referral agencies who meet every care professional in person, and provide matching services for clients. These companies do not shoulder the employment responsibility, or maintain any responsibility for the care professional once services are initiated. The cost of home care is generally a little more than half of traditional agency rates. It is important for clients to understand what taxes or insurances they may be responsible for when comparing rates. Full service agencies may charge from $19-$35 per hour, but should cover all costs of hiring, taxes, scheduling, and insurances.


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