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How Do I Decide

By: Cynthia Ward


When we live at a distance, we have to rely on closer family members, friends and neighbors to be aware of how our parents are doing. Suddenly we can be faced with the realization that loved ones are not getting along as well as in the past. All of a sudden some of the subtle changes that we had been aware of cause us to raise the question, "Is Mom or Dad safe to live at home?" "Are they still able to live independently?" "What can I do to help them manage at home?" We may be aware that loved ones are having problems with health, frailty, or mood.

We can watch for several things that will alert us to a change in functioning. Be aware of:

  1. Mail and bills are piling up.
  2. The house is cluttered or unkempt.
  3. Food in the refrigerator is uneaten or spoiled; food is left out on counters to spoil. You may notice a loss of weight.
  4. There are signs that the stove has been left on; there may be burned patches on counters or pans that have been scorched.
  5. Clothing is not clean or changed regularly. There may be a change in the way clothing is worn such as choosing inappropriate outfits or not dressing for the weather.
  6. The person is not attending to their personal hygiene.
  7. There are missed physician appointments and in general confusion about the time and date.
  8. A parent calls at odd hours or several times a day and asks for help or seems upset, confused or agitated.
  9. Medications are being mixed up, or they are not being taken as prescribed.
  10. There is a loss of interest in activities or social involvement.
  11. There have been a number of falls.
  12. There is a problem with balance and walking. They rely on items of furniture or walls to support them as they move around the house.
  13. There have been automobile accidents or reports by neighbors of unsafe driving.


You may hear statements like "I don’t know what I am supposed to do now" or "I'm confused". You may notice repetition of questions and stories. All of these observations may be indicators that there are problems with mild memory loss or more pronounced problems related to dementia.

How do you decide what to do when you notice any of these signs?

Arranging for a thorough medical examination by a physician is an important first step. The physician may recommend that a more specialized medical evaluation be arranged and will help make the right connections.

Depending on the reason for the memory loss and confusion, plans should be put in place to ensure that matters of safety are addressed. When long term care is recommended by the physician, depending on other factors, involvement in an adult day program or a residential placement may be appropriate.

How do you decide what placement is best? How do you evaluate dementia care programs to be sure that they offer a high quality of care?

For guidance in planning and addressing all of these concerns, a Geriatric Care Manager can help by sorting out the medical problems, determine if the elder is able to live safely at home and recommend what services can be put in place to support the elder and caregivers. The National Association of Professional Geriatric Care Managers provides guidance and information on choosing a Care Manager. The New England Chapter and the National Association provide a "Find a Care Manager" function on the websites: http://www.caremanger.org and http://www.gcmnewengland.org.

For guidance about the best facilities to meet the daily supervision or residential placement needs of your loved one, the Alzheimer's Foundation of America has instituted a Program of Distinction process. You can visit the AFA website, http://www.alzfdn.org for more information about the quality of service review process or call 866-AFA-8484. Programs of Distinction are listed on their website.

Article Source: http://www.content.onlypunjab.com

Cynthia Ward, M.Ed, CCM, CDMS, CRC is a Certified Case Manager and a Professional member of the National Association of Professional Geriatric Care Managers. She is the founder of Chrysalis Case Management, a private case management company. Chrysalis provides care management services to help elders, their families and caregivers plan for aging and long term care.

Chrysalis Case Management PO Box 305 Weare, NH 02381

603-529-7173 www.chrysaliscm.com

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