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Alzheimer's and Dementia Care
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Alzheimer's and Dementia Care

Author: Thoughtful Healthcare

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Tim Tholen, CEO of Thoughtful Health Care, discusses valuable strategies, tips, and information used every day in the care of Alzheimer and dementia patients at home.

Thoughtful Healthcare is committed to providing your loved ones with the very best in personable, caring and friendly at home care. By providing compassionate and professional caregivers a higher quality of life for loved ones under our watch is achieved through advocacy, integrity, continuous improvement and, above all else, honesty.

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10 Episodes
You know it's often been said that America is a car culture. Driving is so ingrained in who we are. It represents freedom, it represents opportunity, capability and responsibility. It's how we get to work. It's how we get our groceries and see our families. It's been estimated that the average American drives 293 hours a year. But what happens when this privilege becomes a risk? What happens when someone really shouldn't be driving anymore? Now I'll tell you from a decade of experience in this industry one of the greatest fears among families of a loved one who has dementia is that he or she will be in an accident or will get lost when driving. So we should consider how dementia affects daily life. Well those effects are very far reaching. And the things that a person was once proud to do are no longer possibilities. And caregivers for loved ones with dementia have more tasks and responsibilities which can feel overwhelming to them, but it's crucial that that caregiver keeps an eye on their loved one's ability to operate that vehicle. Now I'll go over some signs to be aware of. But first let me give an anecdotal example of what I've seen happen when a person with dementia is allowed to get behind the wheel of that car.In other videos in this series I've talked about the warning signs of wandering. One sign is when a loved one with dementia begins to talk about going home even when he or she is already at home. So we had a client whose husband was driving to do an errand a few miles from their house. It's a very simple errand and once he began driving he became disoriented and tried to find his way home. Now obviously after a period of time his wife began to be worried and she started calling family and friends. And later that evening he was found at a gas station about an hour east of their house telling the attendant that he was lost and was trying to find his way home. And this simple errand had become a very very frightening journey for this gentleman and his family. So remember dementia is a progressive disease. Now I might level out for a while, but the symptoms won't get any better. And because of this fact caregivers can expect the symptoms to worsen over time. Now here some signs of some progression in some signals that the time is right to have the conversation about giving up driving altogether. Now a person with dementia might already be aware that driving is scary. He or she might feel fearful or anxious about driving, especially over long distances or to unknown locales or at night. So this is a great time to offer up other suggestions like setting up a Lyft or an Uber account. Organizing a carpool system or utilizing a car service. And once the solution is determined. Then you take away the option of them driving themselves. Don't wait until the progression of the disease wipes clean this moment of clarity of thought.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding area since 1999. Now back to the podcast.Here are some signs that driving is no longer an option. If a loved one gets lost or disoriented in their local environment like a grocery store or loses the car in the parking lot regularly, these are signs that it's time to have the conversation. If there's trouble staying in lanes or an increase in tickets and fender benders these are signals it's time to stop driving. You can also look for signs of mental and physical decline: uncontrollable shaking, poor balance, compromised eyesight. These are all indicators of disease progression, and remember medications may have appropriate warnings about not operating a vehicle while under the influence. So how do you prepare to have this conversation? And as you can already gather this is a pretty tricky subject to bring up with a loved one. Because too many people losing the ability to drive signals loss of independence. But keep in mind your loved one's safety is the objective here and the safety of those around him or her. because with slow reflexes and distractions those can be dangerous to other drivers or pedestrians as well. So begin the conversation by asking your loved one about driving and how it makes them feel. Does it make him feel anxious? Does it make him feel nervous? Then you can echo answers back something like, "I'd be nervous too." Offer some solutions to the problem. Say things like, "Mom, I'm happy to drive you to the doctor just let me know when and where and I'll be there." This puts your loved one in the position of being supported instead of feeling blamed. You could ask a third party professional like a doctor or a lawyer or the insurance agent to intervene on your behalf. This will make it less personal and bring the authority of the professional into the conversation. You can also bring in other family members who can express their concern. But please be sure to focus on the well-being and safety of the loved one and avoid being accusatory. And finally gather concrete examples of instances that illustrate why it's time for the loved one to give up their driving.You should put the plan in place for the eventuality when your loved one can no longer drive. This way, you can let them know that getting around is not impossible. It's merely the mode of transport that needs to change. This conversation may need to happen over time, but do not allow for too much time. And remember to be firm; do not back down. Remember the safety issues at stake here. Now what do you do if you encounter resistance? Because you likely will. Don't give up. Stand your ground. And if you do need to take away the keys, find all of the sets of keys. You can also unplug the car batteries or disconnect the spark plugs. And make sure to put your own car keys in a secure place. Because people with dementia can be very very determined. If you do hire a professional to help with the driving and the transportation make sure they have a clean driving record and do background checks. Also be sure that your insurance covers everything. Remember don't delay having this conversation because your loved one's safety is at stake and our professionals at thoughtful care can help support you when your loved one is no longer able to drive. Thank you.For more information about Thoughtful Healthcare and its services. Visit our website at
When one member of the family has been diagnosed with dementia the dynamic will inevitably change, and some questions will come up like, "Who will make the decisions now that dad cannot? Who will give advice now that mom is unable to? Who will provide the care for your family member? And will there be help in sharing that burden of care?" Emotions can run very high, and family life can suddenly feel chaotic. This is pretty typical of a family who has a member with dementia so take a step back, take a deep breath and begin to take inventory of what you need to do. It's helpful to discuss denial at this point. You know everyone has their own emotional timeline and some people simply cannot handle the news that a family member has been diagnosed with dementia and some deep emotional shifts are bound to occur. The emotion of denial cushions the blow for the person who cannot cope with these big changes, which is a fairly common thing in families where dementia is present. The problem with denial is that it can disrupt caregiving and planning. So those family members who are capable of being problem solvers need to come together quickly for the sake of the loved one who has dementia.Let's talk about some common sense caregiving tips. Now it might not be a walk in the park initially but try to bring the pragmatic caregivers together to get a plan of care in place as soon as possible. Try to take a rational approach to this rather than an emotional approach, and keep the end goal in mind: that the loved one with dementia receives the support and care that he or she needs. And if you're able to keep that goal in mind and avoid any theatrics then the planning will be much easier. However if that's unavoidable then therapist can help facilitate the emotional dialogues for the family in a safe environment, which in turn helps to minimize the anxiety for the person with dementia.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast.So how do we go about delegating this? Well first look for the natural roles within the family. Some people for example are better suited for financial or medical decision making than others, and those others might be better at taking care of the home and the needs within. But everybody needs to have a role, even if the person who lacks pragmatic strengths the plan is there. Don't expect tasks to be divided equally but try not to burden one member of the family with more than what is reasonable. So factor in some of these realities: the geographic location of everybody, scheduling availability, people's natural ability to communicate, their strengths and their weaknesses, their willingness to help and their financial ability to support the care needed. Recognize that everyone is human. So be as patient and understanding as you can with all members of your family.How can you make this process easier on ourselves? First, create some action list within the family to achieve the stated goal. You can use a group email list to keep everyone informed even if they are unwilling or unable to help. Avoid secrecy and be as transparent as possible, this will help avoid many many problems. Encourage everyone to leave their agendas at the door, because having individual agendas in this process will sew chaos. And accept your family members for who they are, not who you want them to be. Finally keep in mind that dealing with dementia is very very hard, that's a universal fact. So seek out support groups through the Parkinson's Foundation and the Alzheimer's Association. Find other people who have dealt or who are dealing with the things you're dealing with, and take notes for what they use to become successful. Some members of the family will not be as strong as others or as helpful. And if you're truly alone in the caregiving role, look for outside help. Whether an in-home service like Thoughtfulcare, community resources or the Internet. Remember dementia progresses at uneven rates and it can take you by surprise. So be prepared. Be patient but be as thorough in your planning as possible and ask for help from your family you might be surprised by who is willing to lend a hand. Thank you.For more information about Thoughtful Healthcare and its services. Visit our website at
When there's a diagnosis of dementia in your family everything changes. There's less predictability there's added confusion and the person with dementia needs more attention. Holiday events can get thrown on their ear. but all is not lost. We have some helpful strategies for you to plan a great holiday. And this might not come as a huge surprise, but flexibility is a key to a successful holiday event.For many families holiday time includes visitors from out of town, extended family, kids and changes of schedule. And all of this extra stimulation can exacerbate anxiety add confusion and create behavior issues in your loved one. Be flexible with your plans and do some preparation to help reduce the stress and keep things fun for the entire family. Let's talk about expectations and why you need to shift them high expectations around the holiday time can be very dangerous. Things get magically easier when we can accept things the way they are. So set a level of expectation for the family before they arrive. Let them know what's really going on because this will help prevent disappointment. And know that family traditions are going to look different from now on and your preparation for the holiday will change.There might come a time when the behaviors associated with dementia require your loved one to skip events altogether. So it's better to prevent a problem than force an issue. So keep an eye on your loved one for the weeks leading up to the holiday events. Outburst, extreme anxiety, inappropriate touching, volatility: these are all behaviors that could disrupt your holiday event. People with dementia can have shifts in behavior in the evening; we call this Sunday morning. So consider moving your holiday events to the daytime to prevent anxiety and behaviors. And Thoughtfulcare provide services during the holidays to help caregivers cope when they're feeling overwhelmed. It's okay to have professional help there if it reduces stress. You might consider making some new traditions now. So for example open a few presents with the person with dementia instead of hoping they will stay engaged. When everyone opens presents. And at some point your loved one will not be able to engage in your traditional family events. So you can do something separately like going to religious service or an outing with other family members after seeing your loved one. And if it's important to your family to carry on religious traditions ask clergy members if they can make a holiday house visit rather than expecting your loved one to sit through a long service.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast.So it's time to plan for your holiday event and here's that word again planning. The more you do to prepare an event the more smoothly it will go. So make sure the event itself is not too elaborate; keep things very simple and very flexible. Maybe instead of having their traditional sit down meal with the whole family you can opt for a buffet so that everyone can enjoy eating at their own pace. And take turns being the wingman for the loved one with dementia. This will give the caregiver a much needed break. There might be a little training that goes with this, letting other family members know what the needs of the loved one are, but it would be good for others to get a feel for what it's like caregiving even if it's just for the evening. It will help if you know what to say before the event. So have a conversation with every person that will be attending before the actual event to bring them up to speed. This could sound something like, "Hey Cousin Carol I want you to know that Mom's dementia has progressed and she's having trouble recognizing people. So please don't be alarmed. She'll probably need to take some breaks when she gets overstimulated." The more you communicate ahead of time and choreograph the event the less explaining you'll have to do.Now we all know there's an importance of communication and everyone needs to remember that the person with dementia might exhibit behavior that seems abrupt or unusual and it's nothing personal. It's part of the disease. Let people know that overstimulation can cause behaviors and there might be a need for breaks in the action. Prepare your family. Get everyone on the same page so that no one has inappropriate expectations or feels left out of the loop. And finally, enjoy yourself. The more thoroughly you can plan for the holiday event with a loved one who has dementia, the more smoothly it will go. However, it might not be perfect. So learn to laugh when you're able to, take things lightly. Watch for signs of stress in a person with dementia and provide them with quiet breaks. Treat yourself and your loved one with the dignity you deserve. If you model this high road behavior conflicts can resolve much more quickly. And finally, enjoy those imperfect moments because they make life unique and memorable. Thank you.For more information about Thoughtful Healthcare and its services. Visit our website at
When we talk about dementia we often focus on the person who's been diagnosed, but caregivers also experienced tremendous changes in their lives as a result of this diagnosis.  In fact studies have shown that people who care for those who have dementia are at risk of developing depression and illness themselves. A 2009 study by the National Alliance for Caregiving and the AARP found that caregivers immune systems are compromised for up to three years after their caregiving experience ends. Thus increasing their chances of developing a chronic illness themselves. Furthermore a study by the Alzheimer's Association found that about 40 percent of family caregivers suffer from depression as compared to between 5 and 17 percent of non caregivers. That study also states that rates of depression increase with the severity of the dementia. So here's some tips for keeping you the caregiver healthy and well.Make sure you have a support system of people who can fill in for you whether it's an adult child a sibling or a professional. It's important to be able to step away and refresh yourself every once in a while because you have a life too. And don't be afraid to pamper yourself whether you take a walk or buy yourself something you've always wanted. Treat yourself. You're worth it. So here's some tips for caregivers. Once a day, take a time out. Determine your level of need for breaks and tailor it to the level of care needed by the person with dementia. Now here's a way to tell if you need some time out. If you find yourself irritated or short or getting in arguments it's an emotional indicator. It's time to take a break. So recognize and address the physical indicators of exhaustion.: fatigue that you can't get rid of, changes in your body such as headaches and colds or new habits that might crop up like eating an excess or drinking more alcohol get the care you need. Consider seeing a grief counselor.Thoughtful health care offers 24 hour in-home care tailored to your loved ones needs. We've been serving Kansas City and the surrounding area since 1999. Now back to the podcast.Here are some more tips. Be very rigorous in your self care. Make a plan that allows you to get plenty of exercise and eat properly. It could be a daily checklist or as simple as putting on a health tracker. But make sure that self care is your priority. Get plenty of sleep and if your sleep pattern is disturbed by a loved one's dementia it's an indicator that you need more help. And make an effort to maintain your social relationships. Go play cards, take a class or see a concert. Even if you don't feel like it. Please don't isolate for your own sake as this is frequently seen in caregivers. Here are some more tips: join support groups. The Parkinson's Foundation and the Alzheimer's associations have them because you're not alone. It helps caregivers gain perspective when they are among other people in the same boat and you might even make some new friends. Keep your stress levels low by setting appropriate expectations. People with dementia don't act this way on purpose and their behaviors may vary. So take every day as it comes. And have the perspective that this is a long game not a sprint. Your own health is your greatest gift. So get help if you need it.You know support from family and friends might not fall out of the sky so you need to ask for help or contact a professional service. No one should be asking you to do this alone. And if you feel that you need help get your help. Our company of professionals that Thoughtfulcare. We offer varying levels of that help from just a few hours a day to 24/7 care. So we're here to support you and your loved one. Nobody said caring for a loved one with dementia is easy. It is a challenge, there's no doubt about that. But rather than looking at the past as a series of exhausting days and at the future as a crisis waiting to happen take time everyday to breathe a little to get perspective and stay within that 24 hour day. It's when you take time to refresh yourself and acknowledge your strengths that you can gain the perspective you need and reach out for help when you need it. And sometimes it's only a phone call away. Thank you.For more information about Thoughtful healthcare and its services. Visit our website at
Planning an Outing

Planning an Outing


Today we'd like to talk about planning outings with a loved one who has dementia. Taking the time to do something special will benefit your loved one by breaking up the week's routine, socializing a bit, and keeping him or her active and engaged. However, the progression of dementia will dictate what's doable for your loved one. But by managing expectations and doing a little planning outings can be fun for everyone.Proper planning prevents problems. If you think of these four P's before going on an outing you're more likely to create an enjoyable experience. You know in my professional and personal experience I've learned that planning is the key word here. Sometimes unexpected behavior or events can occur when taking an outing with someone who has a form of dementia. But you can minimize any possibilities of problems before they occur by following these tips research your outing. Check the websites for your destination for important facility information that will make your outing easier. Is your transportation reliable and safe? How close and convenient is the parking? Is there preferential seating available? Where are the restrooms? How long will the event lasts? Can you leave early if need be? And what's the weather forecast? Watch out for some of these things because people with dementia can be easily overstimulated which will trigger behaviors or outbursts. You know poor weather can be so stressful so it's easier to get around if the weather is nice. Avoid peak hours so that the crowds are manageable. Loud noises and close quarters can be upsetting to your loved ones so look for signs of overstimulation. Like if you're loved one begins to walk away has a flat facial effect or verbal cues or agitation. Try making it easy on everyone. Planning an early arrival to your event ensures that there's no rush. And you can acquaint yourselves with the venue. Having another person with you is very helpful, in case you need to go get some food or use the restroom. And in case your loved one wanders don't rely on them to use a cell phone to find you. Consider and ID necklace or a bracelet. And stick together as much as possible because someone with dementia can get very confused without a familiar face by their side.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding area since 1999. Now back to the podcast.Now let's consider managing our expectations: set them appropriately. It might be hard to accept the changes in your loved one but when the caregiver's expectations are too high tension can begin to rise. For example people with dementia find it challenging to pay attention for long periods of time, so it might not be appropriate to plan outings that require long periods of focus. So if the activity requires an investment of time break it into smaller activities if you can. And remember it's ok to do a staycation like a craft project at home, a fun day of cooking or a movie night. To keep your loved one active and engaged look to your community resources that are appropriate for their needs. A group of peers in a guided setting can give context and provide support for people with dementia and their caregivers. The Parkinson's Foundation and the Alzheimer's Association's websites have lists of organized group outings for people with dementia. And of course are caregivers at Thoughtfulcare can manage an outing so that it is personalized and safe for your loved one. And remember the overall idea is to plan safe and appropriate outings.You know in my field I see people with dementia begin to isolate over time. They might be aware of the changes in their mental state and they simply feel less comfortable in public. And because the person with dementia is less likely to do the things he or she used to do, caregivers can find themselves isolating as well. So caregivers, you might want to find some friends so you can go to your galas and your big sporting events, because your loved one with dementia might not be able to manage at that large event. And staying engaged and active will stave off depression and will keep your loved one in tune with life. So find the middle ground find the things that are fun for everyone. Plan ahead, keep it simple and use resources like thoughtful care to help support you. Thank you.For more information about Thoughtful healthcare and its services. Visit our website at
So one of the many questions we get that Thoughtfulcare is how do I connect with my dad? He has dementia. And we tell them that the goal is to create an enjoyable experience so that you can spend quality time together. And it might not be perfect in your eyes, but it will be so valuable to your dad. It's easiest if we meet the person with dementia where they are, not where you think they should be. So accept them for who they are completely. And know that the process they are going through and will continue to go through will require you to reassess and adjust the strategies that you will use. And while games like Bridge and Sudoku and crosswords, they might work early on, other activities might be more appropriate as the disease advances and you'll will want to be able to adjust to those changes. Take a deep breath. Smile because your positive outlook will set the tone. As the dementia progresses frustration can increase in both the caregiver and the person with dementia. So the upbeat attitude is a winning attitude. In another talk we discuss behavior logs. Noting behaviors can help avoid outbursts by helping the care team to discover patterns and triggers and likewise avoid activities that may increase frustration. Noting behavior will illustrate the times of day when albums tend to happen and then you can plan the activities that are appropriate for the time of day. You know a common saying amongst professional caregivers is you cannot win an argument with someone with dementia. So remind yourself that you are arguing against a disease and that is simply not one you could possibly win. So let it go.When it comes to activities tailor them to create a positive experience. People with dementia are oriented in the past, so go there with them. Share some old movies read some short articles listen to some music from the past. It evokes fond memories. Now other activities can be craft based like painting or making a collage. We've seen families create raised gardens on tabletops or outside that they can tend to. We've put up bird feeders near windows so that families can watch life in action. Or simply go outside the outdoors can be so calming, so just go for a stroll. Here are some more tips for you to consider: break longer activities into smaller activities, it's okay to do a staycation outing so make a fun event at home, again movies can transport people to the past to talk about their favorite movies growing up and watch one together, cooking special foods is a way to connect any old recipes or family favorites will engage your loved ones senses and can nurse them in more ways than one. You could take out that old photo album again. You can have conversations about life events of the past. Now at some point the activities that used to work may no longer be appropriate. So you must adapt to keep your loved one engaged. Please do not use the TV as the primary activity. It is so not good for their brain. And for people further along in their processes the activities need to be much simpler. Just fold some hand towels or opening some mail. And do not stop exercising with them or getting fresh air. You just need to adapt to make it safe and easy.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast.Now people with dementia do tend to get overwhelmed and they may not be able to verbalize their feelings. So watch for some cues that are say enough. Frustration or listlessness. You might listen for verbal cues such as repeating, "NO" or engaging in expressive language. You might look for visual cues such as lack of attention to the activity or restlessness. And when you notice these indicators just change activities or give it a rest. Enjoy what you have done, hold their hand and give them a pat on the back because human contact is priceless and can connect.Now having a conversation with a person who has dementia is an art because their brains will have a harder time processing and understanding what you're saying. Now there's no simple single way to engage, but we've seen some success with the following tips. So in conversation sentences and words should be short using yes or no questions. And don't expect your loved one to remember long details or instructions. You should avoid saying, "Don't you remember that we talked about this already?" because the likelihood is that they don't. And the conversation might be cyclical. So try not to react if the same question is asked more than a few times. You're not alone. Many millions of people are diagnosed with dementia. In fact studies show that starting at age 65 the risk of developing dementia doubles every five years. And by age 85 years and older. Somewhere between 25 and 50 percent of us will exhibit signs of Alzheimer's disease. So use your resources. Contact your local Parkinson's and Alzheimer's Association. They have many activities for people with dementia and caregivers. Group activities can be fun if your loved one is appropriate for them. You should seek out as a caregiver, caregiver support groups because they're important for your well-being and look to connect with others who are in the same situation as you. Please don't give up. Remember your efforts to connect will add to the overall well-being.Get the support you need it's out there and if you want some help. Call us at thoughtful care to be one of our special caregivers. Thank you.For more information about Thoughtful Healthcare and its services. Visit our website at
As you may know, dementia is a progressive disease and having a plan of care so very important. But now we need to look at the costs of care and the available assets to pay for it. Because caregiving can be quite expensive and your family will want to anticipate what's on the horizon. Now this conversation is best done as soon as possible after the diagnosis. Now the term costs is associated with both monetary cost and time spent. And we'll look at some caregiving statistics here and a little bit. But first let's look at the definition of the financial tipping point. And it's this. When the needs of the person being cared for begin to outweigh the ability to pay for the care. Me repeat that when the needs of the person being cared for begin to outweigh the ability to pay for the care. That is the financial tipping point. Now for many families money is a touchy subject, but it is vital to begin talking about it soon because it is the one thing that will drive the decisions about what future care looks like. So First educate yourself about the costs for in-home care assistance and for facility living. Knowing these figures will help guide both the initial planning and the future planning as the disease progresses. And what this means is you should begin to contact both home care agencies like Thoughtfulcare and long term care facilities to better understand their specific costs. Timing is important here. Try to make a plan for the financial aspect of care before any crisis occurs.We've mentioned that time has a financial value. Though it's not seen as a financial cost per say the amount of time a person is caregiving has value and worth. And statistics show that caregiving affects a person's ability to work. According to a study by the AARP nearly seven in 10 caregivers report making work accommodations because of caregiving. Now these adjustments can include arriving late, leaving early, taking time off, perhaps cutting back on work hours, changing jobs or simply stopping work entirely. What this means is that the caregiver's ability to work outside of the home and earn a living is diminished by providing care. So caregiving is real work. It's unpaid often necessary work but it should be factored in as a cost of caregiving.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast.So here's how to begin making a financial plan for your loved one's care. First list all assets and know how long they need to last based on what you've learned about home care versus facility care. Then decide at which point financially speaking moving to a facility will become necessary. You can also talk about personal versus pooled family resources. Now a good home care company will have the experience to know what level of care your loved one needs. So by now you might be wondering what's the difference between remaining at home and moving to a facility? And once you understand the difference you will better understand when it is time to make that move. Now generally speaking it is significantly less expensive to remain at home with some combination of family and home care. But know that as the disease progresses the familiarity of home helps your loved one remain more comfortable and your family can better monitor and control the daily routine because it is your routine. It's familiar to you and your family. Now moving to a facility requires upheaval and a shift to the facility's routine which is a significant change and for some families this is necessary even if it's not the ideal situation. The facility will likely assess your loved one and determine that they are best suited for dedicated memory care which is generally the highest cost of care in a facility. So when making a financial plan, consider this very rough rule of thumb for the cost of one month of facility care. You can have between 70 and 80 hours a week of professional home care. I should repeat that. For the cost of one month of facility care, you can have between 70 and 80 hours a week of professional home care. Now dementia's somewhat of a moving target and that there's a ratio between disease progression and cost of care. Generally the more progressed the diseases the more it will cost for care. And dementia can progress at varying rates and that will throw variables into your care plans. So try to create a few of them for different eventualities, and know that your efforts will not be wasted. There's not one right way to do this, but the best thing you can do is to plan early and adjust your plan as needed. Careful financial planning will give you peace of mind which will allow you to spend more quality time with your loved one. Thank you.For more information about Thoughtful Healthcare and its services, visit our website at
The Plan of Care

The Plan of Care


Why do you need to plan for the progression of dementia? Well dementia's progressive disease. So this means that the need for care will change as the disease changes. And so we want to give you an inside look at a tool that we use in our professional services. It's called a plan of care. So what is the plan of care? The plan of care is a set of documents that will give a caregiver immediate access to all facets of a loved one's life. And why create a plan of care? Creating and following a set plan creates a framework for care that allows for the family member to receive the proper care with no gaps and no holes because inconsistent care can lead to problems and emergencies. I'm going to run through a few scenarios where inconsistent care planning causes problems.Scenario one is Norma. Now nobody has been assigned regular grocery shopping from Mom. We're gonna call her Norma. Norma cannot go to the grocery store by herself, so someone in the family decides to buy her microwave ready to eat TV dinners. Now she can figure out the microwave but sometimes forgets to eat and so she starts to become malnourished. And if a plan of care were in place Norma's family would know who was in charge of making sure she's eating well and staying healthy.Scenario two is Aunt Violent. Aunt Violet has Alzheimer's and needs more care than her family realizes. And Violet spends the day in front of the TV because there's no plan to get her out of the house or engage her brain. Consequently her symptoms of the decline progressed more rapidly. And if a plan of care was in place Aunt Violet would be getting out with family and friends.Scenario number three is dad. Like all dads he's stubborn and claims he can manage his medications all by himself. Little does the family know that at times he forgets to take his morning medications. And when he remembers to take his evening medications he sees the morning ones there and decided to take them both. Family members start to notice some odd behaviors but don't realize they are related to the mis medication. And if the plan of care had been in place caregivers would know to monitor his medications.So how do we organize and plan? Well at Thoughtfulcare, our first step in providing our care is to go to the client's home, assess the living situation, and create our plan of care. Our professional assessment is much more comprehensive because its intent is to manage the care of the client that is hired us. But you can create a simple plan of care at home. And when the time comes for more in-home care. This plan will ease transition for the professional care provider.Thoughtful health care offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast.So let's get started. Bring the family together and figure out roles for each of them. Now some people are more suited for organization and some are better at following directions. Recognize those roles. The plan of care can be created in a Word document or a shared online document that all family members should have access to. Furthermore put the plan in a notebook in the home for all caregivers to read. But be sensitive to the person with dementia's image and share the plan responsibly. So step one is identify your challenges and issues. Medication management, dietary issues, safety in the home, hygiene, transportation, and activities. The plan of care assures that these issues are being addressed every day. So who's giving care for which issue and when.Step two create and use behavior logs. Because keeping track of behaviors helps identify the triggers. And when you make notes of behavior patterns you can begin to recognize when outbursts or confusion could occur. For example your behavior log might show that every day around 4:00 o'clock there is a behavior that just so happens to coincide with the neighbors daily visit. So if you hadn't taken notes on your log you might not recognize the trigger for the behavior is the neighbor. So recognizing the patterns can help you prevent the outbursts.Step three have a safety plan. Many E.M.S. sheriffs and fire departments are starting to adopt dementia protocols. So register with these programs as soon as possible. Have emergency contacts listed in the home and easy to find places like buy the phone or by the computer. As well as in the plan of care book. Now we will talk about wandering and safety in another video segment so check back in for details on those topics.Finally keep the plan current. Note that your plan of care will change because your loved one will change. So update the plan of care is needed. Get a fresh set of eyes would updating your plan of care. Family members who can give an outside perspective like those who live out of town might see changes that those on the inside don't see. If you're interested in a professional assessment and a plan of care as part of our professional care please give us a call at Thoughtfulcare and we'd be happy to help. Thank you.For more information about Thoughtful Healthcare and its services. Visit our website at
Can you possibly prepare for the progression of dementia? You know dementia often means that those who are diagnosed gradually lose the ability to manage their day to day lives. So two questions come to mind. How can caregivers and family members help a loved one with dementia feel taken care of? And how does one take control of a potentially chaotic situation? So in this presentation we'll look at how to address life's details that need to be brought into order so that your family understands what should be handled. And when it should be handled.Today's modern life is so full of complexity and how can you possibly assess it. Well spend a few minutes thinking about your own life and what it looks like. Think of all the passwords to all of your accounts. Think of your cars, the home, and all of the possessions that are in it. Now consider your daily routines. Your life, your work, your hobbies, your children, community involvement, and so on. And now think about how a person with dementia can get so overwhelmed by what were once familiar details. So the complexity of life is undeniable. And one way that you as caregivers can bring order is to create routines. With a diagnosis of dementia the person will need to orient themselves more often and having that consistent daily routine is both grounding and mentally healthy.So let's simplify some things. Consider the fact that if your loved one is of a certain age he or she may not be as comfortable with computers and smartphones as we are. So you may have to take control of some aspects of their life that will require a move to the digital age just to help simplify things. And the more you simplify things like bank accounts and bill pay and appoint reminders the better. And your loved one with dementia will worry much much less when you can honestly say Don't worry Dad is taking care of.So first begin by assessing the existing daily and weekly routines. What happens when. And write it down. You could try setting up a weekly family calendar to put appointments on, as well as caregiving schedules. They'd be in the same place. Here's where you can use technology to your advantage because a shared online calendar lets everyone in your caregiving circle know what is happening when.So let's address and deal with financial matters next because clarity in financial matters is crucial. Now hopefully you and your family members have already communicated with your loved one about what his or her wishes really are. And if not do it as soon as possible because you need to understand the total financial picture. Communicate with your loved ones regarding their financial holdings their assets their debts and their equities. Roundup all of their passwords to all of their financial websites and put them in a safe place. Maybe most important is put alerts on their credit cards to track overspending because you don't want them to make impulse decisions.Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding area since 1999. Now back to the podcast.Knowing the financial story of your loved one's life is very very important, but it's also vital to put legal frameworks and protections in place. So establish powers of attorney both medical and legal. Now this is very important when dealing with dementia because you're going to need to make decisions for them at some point in the future. So designate a family member who is reachable, capable, and preferably experienced in the matters of medical. And legal decision making. And this does not have to be the same person. Let's move on to estate planning. An estate plan will clarify your loved one's wishes and desires in a very real way. And it will also help keep your family out of probate court and it will prevent family discord. Now if your loved one doesn't have an estate plan in place please contact an attorney and establish one. And make sure that everybody in the family knows about the plan but assign one or two people to take charge in creating and administering that plan.Now let's switch gears here and talk about the health of your loved one. You know people with dementia are at risk of becoming malnourished because they can forget to eat or simply lose the desire to eat. So the weekly family schedule we talked about earlier should be specific enough to include meal planning with food delivery if needed. Make sure you're keeping an eye on personal and home hygiene. You know that lack of cleanliness is one of the clearest signs that your family member needs additional care? Part of the routine that you established needs to be that your loved one is getting fresh air and exercise, because this will increase quality of life and help control some of the outbursts and behaviors. Now we can create a care plan book. One of the services Thoughtfulcare provides to create that care plan book and we'll address this in detail in a subsequent video. But what we've found is that families who establish the care plan book on their own before they engage us have an easier transition into professional care. A care plan book simply consolidates all relevant information of caregiving into one book. It's pretty much the kitchen sink of planning, but it's nicely organized. It should include doctor specifics, names of attorneys, emergency points of contact, list of medications, your behavior logs, and your weekly schedule. There should also be a note section where your cast of caregivers can leave notes as to what they saw and did during their time.So can you control the inevitable. No. Dementia is a prognosis without a cure, and its advancement is unpredictable. But what you can do to help manage the progression is prepare for those eventualities. So size up their financials, create or update their estate plan, establish routines, monitor the eating and the hygiene, and put it all in a care plan book. These are all practical steps you can take to bring order and peace to your family which has been touched by the diagnosis of dementia. Thank you. For more information about thoughtful health care and its services. Visit our website at
Mom's been diagnosed with dementia, now what do we do? You know every family with a loved one who has been diagnosed with dementia will have a host of questions including this one, so we've tailored this presentation to those family members who are new to caregiving for a loved one with memory issues and these tips are intended to share our expertise with you so that you can be better prepared for what lies ahead. So what is the diagnosis? It's an important question. Is it Alzheimer's? Is it Parkinson's? Is it Lewy Body or perhaps Frontal Lobe Dementia? These all have specific symptoms and progressions and you need to educate yourself and your family so that you're prepared and can begin planning. So after the diagnosis has been given it's important to pay attention to what the doctor recommends for treatment. Now this treatment could include some new medications and possibly some clinical trials. And these recommendations will provide the basis for the planning that is yet to come. Now it's important to note that dementia cannot be cured but it can be managed with a good plan and the right medications. So let's talk about these medications any new medications need to be integrated into the daily routine because medications can and will help control symptoms and behaviors. You know people with memory loss can forget to take their medications. Compliance is a big big issue here. So please make sure your loved one is taking these medications at both the proper times and the proper doses. Furthermore make sure your doctor is aware of all medications your loved one is taking, so that there are no dangerous interactions. Eating properly is so important for all of us especially for those taking medications because these medicines need to be metabolized properly. So in short make sure your loved one is eating enough. Now let's talk about tracking behaviors and why we do it. Identify the behaviors that you're seeing. This helps with care planning. Keep a behavior log so that you can begin to anticipate the daily ups and downs. So what is a behavior log? A behavior log can be comprised of notes in a journal or Google Docs for example. But it's most helpful if the notes are kept for an extended period of time so you can begin to establish behavior patterns. Now all family members should be able to contribute this log for a couple of reasons. One a shared record allows everyone to participate in mom's care no one feels left out and two a well-kept history shows patterns of behavior.  Let's talk about the stigma associated with dementia because unlike cancer or other diseases of the Body Dementia is a disease of the mind. Thoughtful Healthcare offers 24 hour in-home care tailored to your loved one's needs. We've been serving Kansas City and the surrounding areas since 1999. Now back to the podcast. Sometimes family members of loved ones with dementia might find themselves ashamed of the behavior associated with the dementia because it's causing changes in personality. So accepting your loved one for who they are and where they are in their disease process it's so vitally important because it's not the person who has the behavior it's the disease that's causing the behavior. Keeping your circle of family and friends informed about the disease and its progression can promote empathy and understanding for everyone involved. And now we come to planning and why it is so crucial. Begin to name the people and your loved ones support group and start to establish roles for them. This needs to be as detailed as possible. Who will be in charge of our finances? Who will do her shopping? Who will do her cleaning? Who'll take her to her doctor's appointments and so on and so on and so on. Now be very clear and transparent about available assets including the financial resources because this clarity can prevent possible discord in your family, and it helps you plan for the future care. Continuing to educate yourself about dementia is so important. There are lots of resources available to you both online and in person. You need to ask for help too. You as caregivers need to take the best possible care of yourselves. Did you know that 40 to 70 percent of caregivers have clinical symptoms of depression? And a caregiver's immune system can be affected for up to three years after the end of caregiving duties. These are some heavy numbers. So locate and engage therapists who specialize in aging issues. And certainly seek out organizations like the Alzheimer's Association and the Parkinson's Foundation. They maintain a wealth of resources for you.  Let's talk about the benefits of Care Planning. Timing is important. Inform yourself about outside help as soon as possible because dementia progresses at different rates. Families who have a solid plan of care in place you'll see less caregiver burnout. Also, having a plan in place allows for easier transitions to either in-home care or a long term care facility. You don't want to be the one who calls and says, "I wish I would've called you six months ago." You know, we as professionals see the best outcomes from families who have planned early and planned well. And finally, make the most of the good days because with a diagnosis of dementia your loved one will experience good and bad days. Just because you experienced a bad day does not mean all days will be bad though. You know, the symptoms of dementia are really a series of behaviors that change frequently, so don't get stuck when there's an undesirable behavior. Caregivers who focus on their own well-being create more good days for themselves and their loved one. And finally, be sure to enjoy the good days with your loved one because life is so precious. Thank you. For more information about Thoughtful Healthcare and its services, visit our website at 
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