Memory Care with Teresa Youngstrom
Seniors Need to Know Their Plan B
[ Music ] Hey everybody, Teresa Youngstrom, Memory Care with Teresa Youngstrom, thanks for being here. Today I want to talk about what's a normal progression of things and how do we get help? You know, we find someone in our home who's struggling and I'm sad to say that most people don't ever plan on needing a retirement community or anything. I would think for yourself, are you ever going to be in an nursing home? No? Okay, well, I'd like to say that too. But do you know many of us will end up needing that kind of care? And so it's good just to go over a review about what's out there, what's available, how do we get help, but what are some of the bridges we have to cross and things we really need to think about to get started? If we get on this track with loving somebody, this journey of loving somebody whose brain is failing, we got to take care of us, we got to take care of them, but we also always need to know our plan B, and I've talked to you about that before, you will eventually have to bring help in or they'll have to go to a place. And you know what, even in a place, if you can afford to have help still come in, we can do that. All right, so let's get started. I've got a few slides I want to share with you. Yeah, when and where to get help, so important that you understand this. So let's move forward. So we'll talk a little bit about the normal aging process and what we think is going to happen in our normal aging and what we hope is going to happen. But you know, you better be proactive on that. You know, if you want to live a healthy life, I hope you're eating well. I hope you're exercising. I hope you're using your brain in healthy ways, getting drunk every Friday night or just drinking too much, not drinking every day. I hope you're not a couch potato, and I hope you're getting some exercise and using your brain, and I hope you're getting some decent sleep. Okay, so what's normal aging, some events that could be signs of decline, and then where do I turn for help? That's what I want to cover today. We'll see how far we get because I always have great things I want to share with you. I appreciate you all so much. You are like sharing and subscribing, and it's going so great. So thank you. Thank you for getting the word out that there is hope and help with dementia. Okay, let's get started. So what is normal aging? Is this what your life looks like? I mean, isn't this what we hope our life is going to look like? We're going to do family. We're going to be healthy. We're going to stay social. Maybe we retire. Maybe we don't. Maybe we love our job like me. But, you know, what are we going to do? What are our plans? Are we going to travel? We're going to go on a cruise. You know, we got all these big plans, you know, but this is what the shiny brochure says aging will look like, right? I got news for you. It isn't quite that perfect. And these bodies just aren't meant to live forever. And so they will begin to fail. And so we have to be proactive, be preventative, but be proactive. So here's some things we might see. We might start to see skin changes. Yeah, we might see some skin change. You might see bone changes. Blood vessels may stiffen. It's a part of it. Or maybe they get real obvious. You know, some people lose the fat in their hands and all of a sudden you can count all their veins, can't you? Like you could start an IV with no trouble. Maybe we have high blood pressure causing secondary things. Maybe we're like headed when we stand up, you know. There may be urinary frequency, digestive changes. That happens. Vision and hearing changes for sure. That's normal aging. You know, our teeth and gums change. And so it's just part of it. Don't freak out. You know, I know there are people out there investing in the hair replacement and all the, you know, plastic surgeries and stuff to look young and you know, to each his own. But we are going to have changes. It's part of it. But sign to decline that could indicate maybe that we need help might look a little differently. And I saw, you know, or signs that maybe memory is failing because I know that those of you that are closest to someone, you don't really want to see what's happening. As a matter of fact, people that live together spouses or partners, you know what? We tend to not see or be in denial frequently about what's going on with our loved one. And most of that is because we're so close to it. My dad certainly didn't see the changes in my mom that my sister who would come in every six months would be holy can holy. We got a problem here. And you know, I'm very busy usually in January because family comes home or families visit and then they realize there's been decline that maybe we didn't see over the phone or maybe we didn't, we didn't see because we haven't been there for a while. So this might be a sign of decline, you know, people falling. But it happens. We lose our balance. People are going to fall. We got to be careful. Don't be afraid to go ahead and use the assistive devices, you know, get the walk or get the cane, whatever the doctor recommends. But once there's memory challenges involved, if dad doesn't have short-term memory, is he going to remember to use the new cane or the new whatever? He's not, is he? Okay. So and then you obviously shouldn't say, "Dad, dad, dad." I keep telling you, that's not going to win you any points. What I want you to do is say, "Oh my goodness, dad. Dr. Brown really wants you to use that cane. Dr. Brown really wants you to use that walker. I'm sorry I forgot to tell you, "Oh my goodness." And make it your fault. Okay. And then get over it. Because if you make it his fault, depending on where his brain is, it may not go well. Another sign of decline is his mom or dad ending up being shipped off to the emergency room more frequently. That could be a problem. Okay, broken bones, broken hips, broken things, broken arms because we're going to fall. We got to be careful. Let's think about getting the right shoes. Let's think about getting handrails. Let's think about getting, you know what? You can put a second banister going up and down steps. What? Is that the rule book? Yeah. I mean, if you want it, so people will install a banister on both sides of your steps. Who cares? Just go ahead and get it. What about other signs of decline that might be mood changes or being difficult or, you know, never wanting to go out anymore, being sensitive to everything. Those can definitely be signs of decline, you know? And so, another sign of decline, what if we're not paying the bills anymore? The bill's really building up and maybe dad can't even get to the bills anymore. But what if dad always did the bills and didn't want mom to do them? Okay. We're going to need to come up with a creative. You know, I like creative. Creative way to come alongside and help serve him and he might need to think he's training you on how to do the bills. So, if a son or daughter comes in and says, "Dad, you know what? I really need to brush up on the best way to pay bills. I know you've been doing it a long time and you're good at it if you could show me." Okay. Now, people that don't have the anisognosia, that inability to see their brain deficit, we talk about that a lot. But people that don't have that, they see their challenges and so then they're open to bringing in help. But I'm talking about the ones that are in denial about that, okay? Some other signs of decline. This might be a sign of decline. Wandering is eloping. You know, maybe going out at the wrong time of day and looking for someone or thinking you need to be somewhere, this can be a challenge. Sometimes it's medication related, but sometimes it is memory decline related. Another sign of decline. What if your loved one can't keep their living space anymore? I mean, nobody needs to be perfectly clean or anything. Who needs that, right? Life's too short. But there is an element of cleanliness we need just in order to stay healthy. And honestly, if we don't have a pathway, I mean, I did a lot of people who don't care over the years and I would just tell them, the house doesn't have to be spick and span. But with this situation, it's fall risk every day because everything's two feet deep. And you're stepping over, you know, two liter bottles and newspapers are sliding out from under view and it's definitely a fall risk not to mention hygiene. Oh, we won't even go there. I could tell you a bunch of stories about that and the hoarding thing. And hoarding becomes a problem with a lot of people with memory challenges. Did you know that? Because my brain isn't working, right? And I'm thinking I have to hang on to everything I have. And I save everything. And it also can be what generation you grew up in. Listen, people that grew up during really hard times, during the war days, people that are late 80s, early 90s, maybe 100 right now, they lived through some really, really hard times. And they know you didn't throw away a thing and you could repurpose everything. And so that might be a reason that they're hoarding on the things. Truth is every person's symptoms will be a little different. All right, I think we're familiar with that. But what kind of help? I mean, let's start with those advanced directives. What does that mean? Well, everybody should have a living will. Everybody should have powers of attorney, powers of attorney. You know, when we interviewed Dennis and Keller from the Elder Law Office, he gave us all kinds of great recommendations on that. So go back and watch that episode if you need to. But advanced directives are really important, but it's important that they're notarized. You know what? I know you can get the drugstore brand of these kind of things, but I'm not sure they're going to have all the great information that taking this through an Elder Law attorney would have for you. It's better than nothing, absolutely. But I'm telling you that you need to have the paperwork done prior to losing your memory, too. So why can't you do that now? Why can't you? If you're, you know, 30 years old and you've got kids, why can't you do that now? Make someone else your power of attorney and then change it over the years because people pass away. People, we lose contact with people. Relationships change. That's okay. Or maybe new things, new paperwork comes out that we need on those powers of attorney. I learned a lot about that when I interviewed Denison Keller. So where do we find help? Well, usually people want to stay at home. We want to keep it familiar. We want to stay at home. And so we might get help from family and friends, but we need to decide what they really need. I think there's more help around us than we recognize because I know growing up in the neighborhood where we live, we've watched all of these folks that were older than us and we've been able to help them. And now we've got folks that are younger than us and they're willing to help us. And that's really cool. So being good neighbors is important. And you might be able to find help that way. Family members, another great source of how to stay at home and still be able to do what you need because maybe you're driving. Maybe you're not. Maybe you're able to get your groceries. Maybe you're not. What kind of help do we need? So frequently we might need help paying the bills, especially if we're starting to get to the point where we're losing our cognition a little bit. Maybe we're not remembering to pay the bills, but that can be done by a family member if the person's agreeable, but you can also hire services to do that and have some people don't want family members seeing their bills, seeing their credit card bill and everything. So I think sometimes they want someone else hired in. So go with whatever your situation is. Let's just do that. Grocery shopping, meal prep, housekeeping. There are plenty of home care companies out there that can help you with this. Or maybe find out from your local senior organization in your community. Do they offer anything? Do they offer volunteers that come out once a week, once a month? Even if you had somebody to help you once a month, there are things you could have done. Okay, so housekeeping things, laundry things, pet care, transportation needs. These are things that you can hire out. But sometimes these needs are going to be too great and we need to think about the relationship. Maybe that relationship isn't great. So we need to take it a step further and find more help. I had a gentleman contact me yesterday. Mom's fallen now. She's been in independent living, but probably we need to look for next stage because you know what? She's also not managing her diabetes well. Well, that's important. So if that's an issue, maybe we need to go be not in independent living, but maybe in assisted living. You know, at that level, at assisted living, you can get help with meals and meds. All right? So we do need to ask the question though, your person, if they're living with dementia, are they willing to allow help to come in? Because sometimes we have to be creative with how we bring the help in. Let's look at a few things. Is the home safe? Are the grad bars? Are they on one level? Is their security system or cameras? Is it clean or hoarded? Is there great evidence that they need help? Are they alert and oriented? You know, do they know what day it is? And I don't think it's important to know the date all the time. My goodness, if you haven't worked in a few days, it's hard to know the date. But not a big deal. Do they have anisognosia, the inability to see their own disease? So do they not know that they're forgetful? And they keep saying they've taken a shower or saying that they have paid their bills when things are still stacked up there and their hair doesn't look like they've watched it in a very long time. That isn't when we finger wag them down or argue, but that maybe when we need to come alongside and bring some help in. Okay. Are they in a lopement risk? I showed you a picture about that before where someone gets a wild hair that they need to get that turkey that's on sale for 29 cents pound. But they don't realize it's 2.30 in the morning and they probably shouldn't go out at this time. It's dark and all of that. Are there cooking hazards? You know, are they burning things up frequently? We had a woman who lived in a high-rise and she was getting a lot of complaints. The fire department would get dispatched every time one of the fire alarms went off in the building and that was just the routine. And so she'd get chastised about burning stuff and then the fire alarms were going off too much. So I showed up one day to see her and she had fixed the situation. She had taped a container, a plastic container with duct tape onto the ceiling around the smoke detector because those people just keep calling and I thought, oh my word, can you see a problem here? You can. Okay, so could I. I thought we got to help that. Another situation might be how much money do they have? How much money do they have saved? You know, in America we're really blessed that we have Medicaid and even if there's no money we can figure out how to get care. But it is important to understand the money part and hopefully they'll work with someone who someone trustworthy that will manage their money well but also somebody who can then have access to the money and we can pay their bills in a proper way so we can get them into a good community. Sometimes we need long-term care insurance. You know, more and more. We're living longer. We got to figure that out because going into a community right now you know, if you went into assisted living, you know, you're looking at paying somewhere 5,000 between, you know, it could be $5,000 a month to $8,000 a month depending on what part of town, what part of the country? It could be very, very, very expensive and you know what? It only goes up from there and so maybe we need long-term care insurance. We should think about these things in plan ahead. Lots of services can be hired. We'll wrap up with this and then another time we'll have to talk about what our options are. Where do we go? But lots of services can be hired so we can hire out companion care because maybe dad just needs, maybe you don't live where he lives and he's bored a lot, but someone could come over and help him sort through some things. Someone could take him for walks. Someone could, he really enjoys going out feeding the birds and so they could help him with those things. Maybe they shovel the snow. Maybe he lives somewhere where he needs help with that. But companion care, lunch buddy, exercise partner, these might be some things, transportation to appointments or errands, even social events. You can hire that. Now a lot of times you need to hire somebody for a minimum hours or at least minimum hours in the week. So shop around and whoever you decide to go with, I always give some suggestions depending on what part of town you live in. But I also think it's good to interview those companies. And I want someone to come to the house and tell me about their company, what they do, what they don't do, and let me ask my questions and how soon can they get me a steady caregiver because it's very difficult, especially people that are forgetful to have a different person showing up every day of the week. And that's very, it's hard to develop a relationship and an element of trust where maybe they're going to shower that person or something. But you can hire housekeeping done, laundry done, Medicare, people to walk your dogs. We see that a lot. People to do meal prep or maybe deliver meals, do groceries for sure. You can hire help with hygiene because maybe the only thing Dad can't do is manage the shower. But since she's coming for four hours, guess what? Let's have her flip the laundry, flip the dishes, wipe down the kitchen, and mop a kitchen floor or wipe down a bathroom. You know that's okay. I do these things. I so frequently have people say, yeah, well, there's a caregiver here, but we really only needed her to take us to the grocery. And now she's here for four hours and he's sitting on his phone and I said, oh no, no, no. We have a checklist of what we can do. And trust me, they're expecting to have to do things. So, or maybe maybe you just want to play cards with them. Maybe they're good at Jen Rummy and you could play cards with them. And it still would be something that would be pleasant for your person. So, think outside the box and if you do have help coming in, think outside the box. What can they do? Can they take Dad to a movie? Maybe that's what he loves to do. Can they take him for a walk in the park or her? So, it's hygiene, toileting, med reminders, med reminders. Now, caregivers aren't really supposed to open up the medicine and those things, but they can bring you the med and they can also provide a med. If you put them in the med sets, the Monday, Tuesday, Wednesday, Thursday, Friday, Saturday, Sunday, it has the morning, noon or night type medication selections there. They can do something like that, but they're not really supposed to dispense, like pick up all your pill bottles, read the pill bottle, and then dispense those. That would need to be a nurse in where I come from to do that type of thing. But geriatric care managers, so what if you and your parents live in separate parts of the country, you can hire someone locally to help manage your mom's care. And it's so great because they're going to go over and check on her. They can probably even take her to a doctor's appointment. They can report back. They can take notes and that is a good investment frequently or placement organizations. So, there are several great placement organizations and what they do is come in and find out what your loved ones needs are and then they frequently have their finger on the pulse of what's going on in your community. Meaning they know who just got purchased by another company and have all new staff and things are kind of in disarray. But they also know the company that's had the same director of nursing for 20 years and she knows her stuff or he knows his stuff and they have a great reputation. They know what places the state has been visiting because there's complaints. And so, they get lots of feedback once they help place someone in a certain community. So, you meet with them and then you go look at several places. You know, like I said, they know the best places for your situation, location, dollar amounts, things like that. You know, do you need a place where they can eventually flip to Medicaid? That's important to know. I don't really want you to put mom in this part of town and then in a year or six months have to move her to a complete other part of town. More and more we can even find Medicaid waiver beds. So, even though mom isn't Medicaid now, she will be shortly and depending on the rules of the location, maybe we fit into a scenario where we can get one of those rooms that are called Medicaid waiver beds and mom won't have to change rooms when the money runs out. Wouldn't that be great? Because changing location is so hard on people, especially my people. My people is struggling with memory challenges and dementia. Alright guys, so I hope that was some great information for today. You need to know your plan B, I've told you before. So important. Even if things are going great in your situation right now, know your plan B because situations change. People fall, bones break or mentally we decline or we leave the building several times. And then we realize we need a more secure place to live. Alright, everybody's situation is different and that's how I want to take care of you. Individualized with personal care. I'm Teresa Youngstrom with a better approach to memory care. This is memory care with Teresa Youngstrom. I hope that you will like, subscribe and share. Keep in mind, you got this. (music) (music) (music) (music) (music) [BLANK_AUDIO]