Today we are discussing the tasks that are prudent to have done before a move to a Memory Care facility.
A Visit to the Doctor
First, when someone is having memory problems or other dementia signs, a visit to the general practitioner or a neurologist are in order. That’s because there are a couple of different medical issues that can lead to signs of dementia, but which are reversible. Remember, the definition of dementia is an irreversible and progressive neurocognitive disorder, so you always want to rule out things that you can fix.
The most common medical condition that can mimic dementia is a urinary tract infection. It is counter intuitive, but a UTI, something happening in the groin, can really mess with your cognitive function. But it is easily treated with antibiotics. There are other medical conditions to look at 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. And side effects from medications can be addressed by a medication review. All of these are factors that can lead to Dementia-like symptoms, and all are reversible.
A Dementia Diagnosis
While you’re at the doctor’s, it’s a good idea to get a formal dementia diagnosis. This is a necessary precondition to move into a Memory Care. The reason for that is a Memory Care community is a secure environment. There’s a lock on the front door to prevent a resident from wandering out and hurting themselves or getting lost. This is a necessary safety factor, but we can’t restrain someone against their will without a sound medical reason.
It’s also helpful if the doctor can diagnose what kind of dementia your loved one has. Sometimes this requires a visit to a neurologist or a neuropsychologist. It isn’t always possible to obtain a diagnosis more specific than “generalized dementia”, nor it is absolutely necessary for placement in a Memory Care community. But it is sometimes helpful to have a specific diagnosis so that you the basis from which to anticipate the downward trajectory of the disease, and occasionally it helps in the selection of the Memory Care community.
Legal Papers in Order
Next you need to get your loved one’s legal papers in order. To move into a community you will need to provide them with two powers-of-attorney: Financial and Medical. This is because the community needs to know who will pay for the bills, and who will make the medical decisions. But beyond this everybody needs a will, advanced medical directives, and HIPPA Authorization. A very important point to add to this is that there needs to a backup name on the powers of attorney in case something happens to the primary person listed.
Sometimes I run across a situation where someone with memory problems does not have their powers of attorney in place. In this instance an attorney may not be able to notarize the powers of attorney, because as an officer of the court, the attorney cannot witness a signature if he knows the signer is non compos mentis. A work-around for this that I’ve seen is for the family to download a power of attorney form off of the internet and take the form and the loved one to a bank to notarize the signature. The Memory Care community just needs to paper their files, and isn’t much interested in legal nuances. Financial institutions are another matter.
The third task to have in anticipation of a move to a Memory Care community is completion of a Financial Inventory. This provides a budget for the rest of the loved one’s life. It is up to the family to decide how much money to spend, but one principle is important: if possible, we must try to not run out of money before the end of the loved one’s life.
The financial inventory starts with monthly income from social security and pensions, as well as a conservative estimate of income from savings. Next is the value of a house less the mortgage. Then the combined value of bank accounts, mutual funds and other savings. If long term care insurance or veterans’ benefits are available, then they need to be listed too, as does any other real estate. I don’t usually worry about personal assets like cars, furniture or art work, because it is rare that this category of asset adds much to the total. But if there is a collection of gold coins, that would be nice, of course.
I hope this discussion of tasks to prepare for a move to a Memory Care community has been helpful. Please read my other Memory Care blog posts here for more tips on the process of moving to a Memory Care community. My name is Michael Gill, and if you are interested in Assisted Living, Independent Living, or Memory Care in the Austin Texas area, please call me at (512) 630-7133.
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