Dementia care

Assessment and plan

Perhaps you already have a diagnosis and everyone in the family understands that some changes are in order. Excellent! We can do a casual assessment to help us identify your loved one’s strengths and weaknesses and develop a practical plan for the next steps.

But many families recognize something is wrong, or different, or changing, but aren’t sure what. Perhaps it’s repetitive questions. Maybe sundown syndrome (restlessness and agitation in the late afternoon). By engaging us for a formal assessment and plan, you will gain a 360-degree picture of your loved one’s capabilities. We will share our findings with you in the form of a written or verbal plan. We can speak directly to you or conduct a video-conference call with you and your siblings—even your loved one, if appropriate—so everyone can hear the information at once.

We look at a wide range of issues, including these factors:

• Mental capabilities. How is their logical thinking? Short-term memory? Long-term memory? Can they make reasoned decisions? How is their spatial perception? Are they getting lost or disoriented? What about time? Do they know the month, year, or season? How are their math skills? Organizational skills? Can they realistically still manage their own finances? Our assessment does not lead to a medical diagnosis or treatment (for that, you need a physician). Rather, it identifies existing capabilities to think tasks through, which is necessary for independent daily living, regardless of the disease.
• Medical history. Is there already a formal diagnosis? Does the diagnosis seem to match the symptoms? Have treatments been helpful? Some conditions are often confused with each other and therefore the wrong treatment applied. For instance, many people with Lewy body dementia or frontotemporal dementia are initially misdiagnosed with Alzheimer’s disease. Medication to relieve symptoms of one do not provide relief of symptoms for the other.If your loved one has not had a formal neuropsychological evaluation, we will recommend doctors who do a superb job with this test and walk beside you through the process if you would like. And just because a person has dementia, it doesn’t mean that they don’t also have other conditions that need monitoring. The dementia just makes it more difficult for them to remember what the doctor has told them and to follow through with treatments. You may want us to serve as a patient advocate to track the details and support your loved one in following the doctor’s recommendations.
• Safety of independent living. People with mild cognitive impairment (MCI) can live safely at home as long as precautions are in place and there is periodic monitoring to catch any worsening of symptoms. Persons in the more moderate and advanced stages of dementia will need more supervision. If aging in place is preferred, we can work with you to find in-home caregivers. If home care proves too expensive, we can work with you to find the best memory care or best assisted living in the greater Phoenix area.
• Driving abilities. No one wants to “take away the keys.” Fortunately, there are many avenues to pursue before this big step becomes the appropriate solution. It’s not an all-or-nothing issue. Dignity and independence are important for your loved one’s quality of life. Allow an expert to explore the nuances: Perhaps have an occupational therapist conduct an evaluation and suggest appropriate restrictions for safety. And when the time comes, we can file a Driver Condition and Behavior Report with the Motor Vehicle Department and help transition your relative to “driving retirement.” Together we will create a senior transportation plan that will be workable for all.
• Socialization and quality of life. Just because a person has dementia does not mean that they need to be isolated from others. Nor does it mean that they no longer need or desire stimulation. (Wandering may be a sign that your relative is bored and needs more engagement.) While too much stimulation can cause problems, people with dementia actually flourish when activities and social settings are tailored to their current capabilities.

Based on our findings, we’ll make suggestions concerning next steps of action to address those areas where your loved one needs more support. We can do this as a written plan. Or we can talk through it over the phone or in a Zoom meeting with other family members in attendance. You can decide as a family if you want to implement some or all of the plan yourselves, or if you’d like to hire us for ongoing care management.

To learn more, give us a call at 623-776-3098.
Or schedule a free initial consultation.

Aging in place

If the goal is for your relative to remain at home as long as possible, we will review the findings of our assessment and make recommendations for aging in place. There might be technology that can cost-effectively address safety concerns: Perhaps a sensor that turns off a stove burner when no one is in the kitchen. Or an automated medication dispenser to provide the right combination of pills at the right time. Maybe a sensor is in order to track nighttime restlessness, insomnia, or wandering. In addition, we’ll look at a personal response system to summon help if your loved one were to fall.

Many people with dementia experience problems with spatial perception. They get lost when walking or driving. Or they drive very slowly or make driving errors. In such a case, we will help create a plan for senior transportation so your loved one can safely get to where they need to go.

We will look at executive function and their ability to pay their bills and manage finances. If help is needed, we can recommend a licensed and insured daily money manager to come in twice a month or at appropriate intervals to assist with bills, bank statements, and preparing documents for tax time.

A big problem with aging in place, compared with memory care or an assisted living community, is the lack of social interaction with others. This is especially true for persons with dementia who tend to withdraw from social settings or are no longer included. Looking at your loved one’s patterns before their cognitive problems, we can come up with a plan that allows them to socially engage as much as they can or want to. We will also work on senior-friendly technology so you and your relative can stay in touch using video conferencing. While not quite as pleasant as in-person visits, video calls have been shown to be very effective in reducing loneliness.

What will happen in an emergency? A fire? A fall? Power outage? Together we will address an emergency plan appropriate to your loved one’s abilities so you can rest easy that the situation is covered. From our 24/7 on-call Peace of Mind program to packing a “go bag” and arranging for a family communication plan in the case of emergencies, we will help develop strategies for safely aging in place despite your loved one’s dementia.

Caregiver stress

It is not uncommon for the spouse of a person with dementia to have medical issues of their own. Plus, the stress of daily care can cause their health to decline, sometimes faster than that of the person they care for! If the plan is to age in place and there is a family member living in the house serving as the primary caregiver, we highly recommend addressing the stress and physical impact of providing care. It could be that they need encouragement to stay on top of their own doctor visits and follow through with recommended treatments. Depression is extremely common for family caregivers, especially those who live in the same home 24/7 with a person who has dementia. Perhaps periodic home care or some other form of respite care is in order so the family caregiver can get a break from the constant responsibility.

Caregiver Coaching

Our Caregiver Coaching program allows you to consult with our experts by phone, email, or video conferencing to get your questions answered. Topics might include the following concerns:

• Dementia strategies. Most of the conditions that cause dementia are progressive, meaning they get worse over time. This means your relative’s abilities will change, and so might their personality and behaviors. Normally fastidious mom may refuse to change her clothes or take a bath. Usually proper dad may start making advances to strangers or use rude or offensive language. It can be very confusing. As experts in dementia care, we can coach you through these difficult scenarios and teach you proven techniques for reducing their frequency and managing them effectively when they do occur.
• Work–life balance. You may find yourself having trouble juggling your caregiving tasks with all the other responsibilities in your life. As an adult child, this may be affecting your work, home life, finances, leisure time, your own sense of self. You are not alone! Let’s talk through your issues and develop a plan to ease the stress.
• Local resources. The eldercare system in our country is very confusing. So many different providers, rarely connected to each other in any official way. It’s hard to know who to turn to as different support needs arise, let alone which company is the best of all the options. Put our experience to work for you. We have been working in the Phoenix area since 2009. We know all the local providers, and frankly, we know which ones provide the highest quality. We also know about local programs that offer free and low-cost support and can recommend those when they are available. Save yourself time, money, and do-overs by finding the best providers that will fit within your family budget.

Thoughtful Engagement™ enrichment activities

With all that you do to meet the care needs of your relative, it’s hard to find the time and energy to come up with enrichment activities they will enjoy. Even people with dementia need and deserve a reason to get up in the morning, something to get excited about. Our Thoughtful Engagement™ program creates enrichment activities tailored very specifically to your loved one’s interests and current abilities. It also provides you with a bit of respite so you can replenish your own well. Even if you live far away, it feels better knowing your relative is getting much-needed social engagement and mental stimulation. If you are looking to reignite joy in your loved one and get some relief for yourself, call our Thoughtful Engagement specialist at (623) 776-3098.