Memory Care Communities: Things that should be done before the move | Part 1 of 3


Michael Gill

Austin Senior Living: Solved! a transcribed interview with Michael Gill, CEO Texas Senior Living Locators, interviewed by Grace Lanni, All About That Brand.

Grace Lanni: I wonder, are there things a caregiver should do before looking for a Memory Care community? Is there a step one for this?

Michael Gill: Every family’s situation is different, and everyone starts the journey at a different point. But before a family caregiver starts the search for a memory care community it is prudent to have certain basic tasks worked out. Usually, when somebody is experiencing some memory care problems, a visit to a general practitioner and perhaps neurologist are in order. That’s because there are a couple different medical issues that can lead to signs of dementia, but which are reversible. True dementia is an irreversible progressive disease.  The first and most common medical condition that can mimic dementia is a urinary tract infection. It’s counterintuitive, but a urinary tract infection, something happening in the groin, is actually Once diagnosed, a course of antibiotics can solve that. There are other medical conditions to look for as well. Dehydration, for example. More serious is hydrocephalous, which is water on the brain, and which is reversible with surgery. Thyroid disorders can be successfully treated with drugs. All of these can lead to dementia-type symptoms, and all are usually reversible. If they are reversed, obviously there’s no reason somebody has to leave their home. That’s the first thing that we always have to look at.

Grace Lanni: Got It. And, is there anything the family needs to take away from that doctor’s office in order to move to the next step?

Michael Gill: Yes, Grace. One of the things that a memory care facility needs to admit a patient is a dementia diagnosis from a medical professional. The reason for that is Memory Care communities are always secure. There’s a lock on the front door to prevent the residents from wandering out and hurting themselves or getting lost. This is a necessary safety factor, I’m sure you can imagine, as people can’t be a restrained against their will. A dementia diagnosis is a mandatory requirement for moving into a Memory Care facility.

Another take away from the doctor’s office that is helpful—but by no means mandatory—is a diagnosis of what form the dementia takes. Unfortunately it can be devilishly difficult to get a correct diagnosis in the earlier stages of dementia. The only conclusive diagnosis of most forms of dementia is via an autopsy. This is true because there aren’t many non-invasive diagnostic tools. Brain scans, the obvious way to diagnose a brain condition, often aren’t sufficiently sensitive to distinguish between normal aging and Alzheimer’s. Frontal lobe dementias (Lewy Body, Parkinson’s dementia and Fronto Temporal Dementia) usually are diagnosed from their unique symptoms. Brain scans can successfully see some brain stroke damage, but even then the resulting diagnosis may be equivocal. And people can suffer from multiple types of dementia at once: vascular and Alzheimer’s, for instance.

So while a definitive diagnosis may be difficult (and your doctor may be reticent to give any opinion for fear of giving a misdiagnosis), it is still useful to ask. This is because the characteristics of certain dementias may help the family with their decision process. For example, in my experience, persons who suffer from Frontal Temporal Dementia (FTD), need more elbow room. They don’t do as well in smaller personal care homes as they do in larger facilities where there is more room and activity to engage their brains. Other dementias, such as Lewy Body dementia, frequently have a more rapid decline than other diagnosed dementias. Any insight into the length of a dementia sufferer’s lifespan can help the family financially plan for their care. So having an idea—however vague—of the path ahead can help the family cope with what is to come and can assist in making the best choices possible once the search for a memory care community begins.

Grace Lanni: Very interesting. What other preparations are important before moving into a Memory Care community?

Michael Gill: The family must have powers of attorney for their loved one, as well as other documents. I cover these items in another discussion, so I won’t go into too much detail here. But most memory care facilities won’t accept someone without proper powers of attorney, both medical as well as financial. This can present a challenge when someone has dementia, because they arguably aren’t in a fit mental state to sign legal documents. Lawyers, as officers of the court, are required to assess the mental state of their clients. I’ve seen families download powers of attorney documents off of the internet and go to banks to get signatures notarized. Other documents that are necessary to have, though not solely for or required by a Memory Car community, include a will, directives to physicians, and HIPPA release forms.

Also necessary is an inventory of income and financial assets. Most often this means listing how much monthly income someone receives from social security and pensions, compiling an approximate value of savings and investment accounts, plus the value of any real estate. Of course there may be other assets, but these are generally the most common categories. It is important to plan financially to take care of someone for the rest of their life. This inventory is a necessary prerequisite for placing someone in a memory care community.

Read Part 2: Deciding when the time is right

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