Tag Archives: nursing homes

The $pending of the Green

On this St. Patrick’s weekend, we seen green everywhere — even in the new leaves on the trees. But if you are a caregiver for someone with dementia, you’re probably preoccupied with a different kind of green — the U.S. dollar variety which can be consumed very quickly by dementia care. The next few articles on this site will discuss some factors that may help you stretch your resources.

Every day I thank the moon and stars that my mom planned her financial future with so much care. She was not a wealthy person, but she worked hard all her life and maximized her retirement savings. As her power of attorney, I feel that it’s my job to be a good steward of her resources and — with my sister’s help — I keep trying to anticipate her future needs as we manage current ones. A few basic factors can make all the difference between balanced financial management and disaster.

1) Long Term Care Policies — Our Mom bought a good one through AARP a long time ago. Thank heaven for that! We have been able to use those resources to pay for adult day services and the occasional caregiver break  for me. These funds allowed us to provide her with very good care at minimal cost for nearly two years. The same amount of money would have purchased just three months of care in a private nursing home. If dementia runs in your family, I suggest that you do some research on these policies now and consider buying one for yourself. But be sure you check out the fine print on benefit payments before you sign a payment agreement. If your loved one already has a policy, shop around and see what programs and services are covered. Do some projections to ballpark the long term costs.

2) Get the best, most specific diagnosis. The hardest aspect of financial planning is uncertainty over the duration of the disease. If your loved one has a straightforward case of Alzheimer’s, you may be providing care for a long time. You’ll need to forecast how much and what kind of care you want to buy. Other types of dementia, however, often have a shorter course of development, but may need more intensive services. The only way you can plan well is by getting a diagnosis that is specific enough to help you predict the symptomatic path of the disease. If you are just working with a family physician, you might want to start looking for more specialized diagnostic services at a regional Memory Center. It’s worth the effort to get a more detailed diagnosis. Medicare will usually cover diagnostic visits to a specialized dementia doctor. (But always check first!)

3. Settle your family business. If you are a member of a family — and who isn’t? — then you know that no matter how much people love each other, there are often disagreements about assets, who will control them, and how they should be used. Too many times people carry childhood grudges into adulthood. And families keep adding members all the time (grandchildren, in-laws, ex-in-laws, etc.) so there is literally no end to the potential number of disagreements that can be triggered by asset questions. Now is the perfect time to call a truce. And ENFORCE it! The more you can get family members to agree around a plan of care, the better off you’ll be. Get everyone to collect information about nursing homes, home-based care, and regional care options as a group. Then sit down and share the information. If decisions are made in haste by one person, some family members may get embittered because they’ve been left out of the process.  Try to find your common ground before the disease backs you into a corner.

The most important thing you can do as a family is work together on behalf of those you love. Property has a value that is vital to the care equation — but love is all you have left once that property is gone. Don’t squander it!



Making Dreams Come True for Dementia Patients

For many families, placing a loved one in a nursing facility is a dreaded choice made only when every last option (and caregiver) is exhausted.  But a move may be necessary once a person’s medical needs exceed our expertise and stamina. Care in a nursing home can still be very personal if family members visit often and get involved. Here’s a story of how one loving caregiver enriched the lives of dementia patients at her mom’s skilled nursing residence by starting a “dream fulfillment” program.

Ms. Z. began her work by persuading the facility to add more cultural activities that resonated with the lives of the residents. That meant putting rice and beans and soul food on the dining menu for the home’s many Latino and African American patients. She helped find volunteers to paint bright, live-affirming murals in the drab hallways. Then, after completing these smaller scale projects, Ms. Z helped launch a campaign to raise funds for a Second Wind Dream program. This program is operated by a national organization headquartered in Atlanta, GA. Second Wind Dreams works with communities to discover and fulfill the dreams of elders living in nursing homes, assisted living facilities, and hospice centers. A primary goal of the Second Wind program is to change the perception of aging.

According to the organization, “A Second Wind Dream® is when a group of visionary believers enable an elder to awaken their dreams, often hidden or forgotten.” When such a dream is fulfilled, it “renews hope and champions further dreaming.”  The program works with member communities to discover and fulfill the dreams of elders at the member site. In the facility where Ms. Z.’s  mom lives, they were able to get a local philanthropist to donate the fee required for membership in the national network. To fulfill one resident’s dream, the group had Mario Andretti visit the site for an afternoon. To link the resident’s dream to other community activities, they also had a mural of Mario Andretti, Larry Holmes, and Chuck Bednarik — local heroes for the home’s Lehigh Valley residents — painted in the hallway. Staff and volunteers developed a process to get elders to tell them their dreams which are now fulfilled once or twice per month. In addition, the facility now has a “dream celebration” every three months.

The volunteer group has organized fundraising events to pay for some of the dreams which have included flying family members in for visits or taking a resident to Niagara Falls. But the nursing home has a multi-ethnic population and some dreams have been as simple as having a favorite childhood food — like collard greens or sweetbreads — served on a special day. One resident had an eyelid that never went down and was able to get a new prosthesis to help her lower the eyelid. You can read more about  fulfilled dreams at www.cedarbrookdreamcatchers.org , the URL for the Pennsylvania site. Second Wind Dreams is celebrating a national anniversary on January 13th ,2011 and hopes to fulfill the dreams of many people across the country that day.

For Ms. Z.’s mom, the dream was seeing her whole family together. This involved transporting 25 people from around the U.S. to celebrate her “half birthday” in July, when snow could not ruin their travel plans. What a joyful day that must have been! Fulfillment of a dream like this make our waking lives more vivid and rich. Consider helping an elder realize a long-held dream at this emotion-filled time of year. Next week I’m taking my mom to see the Christmas tree at Rockefeller Center. It may be our last chance to make this trip, and I want her to be as happy as possible. Plus, she’s not the only dreamer in the house.