Listen to Volume # 020 — Yvonne Ortega – “Dementia with Yvonne Ortega” (Podcast)

“Caregiving 101” on KKYX Radio 680am San Antonio, Texas
Hosts: Starr & Bob Calo–oy
Guest: Yvonne Ortega
Broadcast Date: July 5, 2008

Dementia patients often lean-toward being violent, non-verbal or depressed. These are generally the three categories they fall-in.  Deep inside most of them know something is not quite-right any more, and this often contributes to this behavior.  Sometimes aggression is nothing more than self-frustration.

Now there is a test that can be given by your neurologist, and if you have a relative that has been diagnosed with Alzheimer’s disease, you can ask if you can have the test run to see if they have this gene. This can give you an idea of what may be coming down the line, so that you can prepare for it.  For-warned is for-armed.

Starr & Bob Calo-oy created CaregiversAdvice.net to help, encourage, and support caregivers. Through weekly Radio Shows on KKYX 680am San Antonio, they host special guests who cover many unique topics concerning caregiving. They also have weekly TV Segments on KENS TV 5 San Antonio where they share caregiving and marriage tips. All of these programs are archived as Radio Podcasts and TV Podcasts for your easy listening. Visit their sister site, Marriage101.net for marriage help and encouragement. Starr has written Four Books on Caregiving.

One of the reasons personal care homes are difficult to locate is because they don’t have the budget to run large ads in the newspaper, and most don’t have the resources to advertise on the internet. The Alzheimer’s Association provides families with a list of personal care homes, if they feel that this option is best for them. Most senior citizen centers and social workers at almost any nursing home maintain their own lists of referral sources. The best way to find exactly what you’re looking for in a facility is to “do your homework.”

Take a look at the following list of questions. Think about what you would want in a personal care home and answer the questions for yourself, then call around to different facilities and ask to talk to the owners. Conduct a phone interview with the owner of the home and ask them the same questions.

1. How long has the facility been in business?
2. How many residents do they care for at one time?
3. What is the staff to patient ratio?
4. How many people are employed there?
5. How many bedrooms do they have?
6. Do they provide transportation to and from doctor visits and is there any charge for this?
7. Is special assistance with bathing, dressing, and toileting provided?
8. What is a typical daily menu?
9. Do they know how to prepare food for special diets such as diabetic, low sodium, or pureed diet (this applies only if your loved one is on a specific type of diet)?
10. How much experience do they have with hospice care?
11. What will you do if my loved one has to get up at night?
12. Is there an exercise program available for the residents?
13. What kind of activities do the residents participate in?
14. Can my loved one keep his own doctor?
15. Can my loved one use his own furniture or do the rooms come furnished?
16. Can my loved one bring his pet?
17. Can my parent have a phone in his room?
18. Can I come and have dinner with my loved one occasionally?
19. What is the monthly fee?
20. Are there any other monthly costs?

Ask these questions during every phone interview and then compare all the answers. When talking on the phone with the owners listen for and make note of any noises you hear in the background. Compare all evaluations in their entirety when you’ve finished interviewing. Select your top three choices and compare those with the questions you answered yourself. See how close a match you can get.

Don’t feel obligated to make an appointment on the spot. Explain to the owners that you are just making phone calls at this point and that you will call back when you’ve made a decision.

After you’ve conducted your phone interviews and decided on a few facilities to consider, make an appointment to go visit their homes. When you arrive at each home, pay close attention to the following details:

1. What kind of neighborhood is the home in is it a place where you would feel your loved one is safe?
2. How does the yard and grounds look – is it clean and well-maintained?
3. Notice the smell when you walk in the building – is there any smell of urine, mildew, etc?
4. Does the house look cluttered or in good order?
5. Notice the number of staff that is visible
6. Notice the appearance of the other residents – do they look happy and well taken care of?
7. What were the residents doing when you arrived?
8. Ask to use the bathroom, and check it for cleanliness
9. How did the employees accept you when you came in – were they courteous and accommodating, or did they seem hurried and indifferent?
10. Does the house feel like an inviting and cheerful environment?
11. Notice how the staff interacts with the residents
12. Do the owners live on site?
13. Was the owner or person you spoke with on the phone look neat and clean?
14. Ask where the staff sleeps in proximity to the residents
15. Ask how long the current residents have been living there
16. Ask how the staff will know if your loved one needs help during the night
17. Ask yourself if you would feel comfortable visiting your loved one there
18. Ask if the owner/manager has any objections to your contacting the families of their residents

Don’t fall into the trap of basing your final decision on the proximity of the home; allowing that factor to override the quality of the care provided there. All too often, families care more about how convenient it is for them or friends to visit, than the quality of the care. So what if the home you are the most comfortable with leaving your loved one in is across town. If that home scored the highest on your list, make the sacrifice. Your loved ones comfort, peace of mind and security far outweighs your convenience doesn’t it? It should!

If your loved one is a hospice patient or has dementia, expect the monthly fee to be higher. There is much more care and attention to detail required when caring for someone who is dying or confused. Just keep in mind that their money is there for THEM, their comfort and that they should be made as comfortable as possible these last months or weeks of their life as you can possibly make them. Keep it in proper perspective. If they are in the final stages of life, it won’t cost you or your family for very long. It will be over soon and you don’t want to be feeling any guilt about saving a few dollars when you are attending their funeral. Many people spend more money on the funeral than they ever did for their loved ones care. You must consider all of this when making plans for someone to take care of them.

Also, if you just try to save money, disregarding the care (and you are truly able to afford better care), you may find that in a few months, that you got what you paid for and end up having to put them through an uncomfortable move anyway.

There are no shortcuts when you are dealing with somebody’s life. Take the time to make a quality decision and when all is said and done, you will have peace and so will your loved one.

This month I have put together a list of questions for you to answer that they will most likely need to know. It may take you a couple of weeks to accumulate all of the information below but it will be well worth it. This will give you and your children peace of mind.

Sometimes our lives can drastically change due to illness or even end suddenly and our adult children are left with difficult decisions to make. They find themselves scrambling to locate a wide variety of documents while wrestling with a kaleidoscope of emotions.

It is up to you whether you want your relatives to know you have all of this information in one place but I strongly suggest that you consider only letting your power of attorney, estate manager and lawyer know for safety sake. Money does strange things to relationships. It is extremely important to have spiritual advice and prayer from your covering- your pastor, for divine protection and wisdom when making your plans.

So, let’s get started. Get a new spiral notebook to document your instructions and wishes, a plastic file box to hold the files you are going to organize and alphabetical dividers.

1. Who is your family attorney? Place his contact information in a folder marked “Attorney”.
2. Do you have a power of attorney? If so, place the legal POA paperwork (originals and three copies) in a folder marked “Power of Attorney”. If not, appoint someone you trust. Make sure your attorney understands the type of POA needed to carry out your wishes and to have access to all of your holdings for your future care. The POA expires at the time of his death. It would be wise to designate a secondary choice in the event of the primary persons’ illness or death. You need to have the POA notarized in the presence of two witnesses who do not have any interest in his affairs. The attorney will go into more detail regarding the types of POA’s and the rules specific to each.
3. Do you have a financial planner or an accountant? Put his contact information in a folder and label the tab accordingly.
4. On the spiral, make a page to list where all of your bank accounts are, including their addresses, phone numbers and the names of the people you usually deal with there. Make sure you list the exact, correctly spelled passwords and account numbers. Don’t forget to list the savings accounts separately, along with their passwords.
5. Do you have a current will; where is it and is it exactly the way you want it? If you want to update it, call your attorney and make an appointment but in the meantime, put the current will in a folder along with three copies. Your estate manager and attorney should also have copies.
6. Place your marriage certificate in a folder. If your spouse is still living, you will both need this so benefits can be filed for in the event of death.
7. What current life insurance do you have? Where are the policies located? Have you been dealing with a particular agent? Where is the contact information located? Gather all of these papers together and place them in individual folders and mark the tabs accordingly. Do this for both you and your spouse.
8. Do you have funeral insurance? Where do you keep the paperwork? This will all go into a file marked “Funeral Insurance”.
9. Do you have funeral arrangements made with a specific funeral home? Where is all of your paperwork located? This will go into a file marked “Funeral Arrangements for __________”. Make 2 files if your spouse is still living.
10. Make a list of all of your current credit cards, contact information and the passwords on each.
11. Do you own any property? Write down the details in your spiral. If there are any existing deeds, place them in a file marked “Property Deeds”.
12. If you have title deeds to automobiles, place them in a file marked “Auto Deeds”.
13. Do you have a safe deposit box? List in your spiral where it’s located, the password and account number. Tape a copy of the key on the inside of the folder.
14. Do you have a pension or retirement plan with any of your former employers? Place all paperwork relating to the evidence of it’s existence, including contact information and key people involved in a folder marked “Pension Plan”.
15. Do you have any CD’s or IRA’s? Who do you have them with? Place all paperwork and certificates in a folder and mark it accordingly.
16. List all of your assets and debts on a sheet of paper, make a file and date it. Update this information at least annually.
17. If you care to, plan your funeral, plan the music, the selection of pallbearers, the soloist and you can even write a message to your family and friends to be read at your funeral. Make sure it is a positive and edifying message though! Place the plan in a folder marked “My Funeral Preferences”.

Place your spiral in a folder marked “Vital Information”.

The wisest place to store this file box is in a safe and the combination should be given to your attorney, estate manager and placed on a piece of paper in a safe deposit box at the bank. If you do not own a safe, place the file box in your attic but be sure to notify the people mentioned above of its whereabouts.

This will take time to gather but you must have the information at your representatives’ fingertips at any given time so get it done. Don’t put it off.

If you are reading this article and want to do this but need some help, ask your POA to help you. Enlist the help and legwork of trusted family members but only after consulting with your POA to know who to include. You may need to divide up the list among several people. Call a family meeting with a few of the more organized and diligent members. Schedule the next meeting with them (have them bring their weekly planners or calendars with them) before they leave.

This may sound like a lot of unnecessary work especially if you’ve never been through having to search for such information after the death of a loved one personally. In that event, you have no idea how important it is to get it done right. If you have been through it and not been this organized, then you will appreciate our attention to the small details. One thing is for sure though; your children and/or loved ones will truly appreciate this act of love and consideration.