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Practical information for aging health & family caregivers

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Incompetence & Losing Capacity:
Answers to 8 FAQs

by Leslie Kernisan, MD MPH

Depositphotos_9669220_m-2015-brain-cogs-leaving-compressor

Have you ever been concerned about an older relative who seems to be making bad decisions?

Perhaps your elderly father insists he has no difficulties driving, even though he’s gotten into some fender benders and you find yourself a bit uncomfortable when you ride in the car with him.

Or you’ve worried about your aging aunt giving an alarming amount of money to people who call her on the phone.

Or maybe it’s your older spouse, who has started refusing to take his medication, claiming that it’s poisoned because the neighbor is out to get him.

These situations are certainly concerning, and they often prompt families to ask me if they should be worried about an older adult becoming “incompetent.”

In response, I usually answer that we need to do at least two things:

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Managing relationships, Q&A Tagged With: capacity, dementia, memory

5 Things to Know about Aging Parents & Financial Decline

by Leslie Kernisan, MD MPH

Aging woman counting money

You probably already know that many older adults develop problems managing finances as they age.

Now how would you answer the questions below:

  • Has your aging parent planned for a decline in financial abilities?
  • Are you prepared to detect signs of a financial decline?
  • Do you know what to do if you do notice problems with finances?

Many people, even the ones who are caring and well-informed, will often answer “no” to these questions.

But this post will equip you to start answering yes. And I want you to be able to answer yes, because declines in the ability to manage finances are very common among older adults, and often causes serious health and life problems.

The trouble, of course, is that financial decline is uncomfortable for older adults and their families to think about. Managing money, after all, is one of the ways we maintain autonomy and control over our lives.

So nobody likes to confront the fact that our ability to manage money will — in all likelihood — someday decline. (Research suggests that even aging adults who don’t develop dementia often experience declines in financial ability.) And families are understandably squeamish about monitoring an older relative’s financial abilities.

Fortunately, a little education and guidance can make it much easier to be more proactive about this tough topic.

In this post, I’ll cover

  • Five warning signs of financial decline
  • Five important things to know about aging & finances
  • How to protect aging parents from financial problems
  • What to do if your aging parent is having trouble managing their finances

I’ll also cover some ways that geriatricians and other healthcare providers can help, both to reduce declines in financial ability and to properly evaluate them when they occur.

5 Warning Signs of Financial Decline

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: financial concerns, memory

8 Behaviors to Take Note of if You Think Someone Might Have Alzheimer’s

by Leslie Kernisan, MD MPH

Have you been worried about an older person’s memory or thinking skills? If so, you’ve probably found yourself wondering if this could be Alzheimer’s, or another dementia.

What to do next? If you look online or ask people, the advice is generally this: tell the doctor.

This advice isn’t wrong, but it’s incomplete. Yes, you should tell the doctor. But you’ll dramatically improve your chances of getting to the bottom of things if you come to the doctor with useful information on what you’ve observed.

In fact, research has found that interviewing family members about the presence or absence of eight particular behaviors can be just as effective, when it comes to detecting possible Alzheimer’s, as certain office-based cognitive tests.

8 Alzheimer’s Behaviors to Track

For each of these behaviors, try to make note of the following:

  • Whether there’s been a decline or change compared to the way your parent used to be
  • Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
  • When you – or another person – first noticed problems, and what you observed
  • What kinds of problems you see your parent having now

If you don’t notice a problem in any of the following eight areas, make a note of this. (E.g., “No such problem noted.”) That way you’ll know you didn’t just forget to consider that behavior.

Have you noticed:

  1. Signs of poor judgment? This means behaviors or situations that suggest bad decisions. Examples include worrisome spending, or not noticing a safety issue others are concerned about.
  2. Reduced Interest in Leisure Activities? This means being less interested and involved in one’s usual favorite hobbies and activities. You should especially pay attention if there isn’t a physical health issue interfering with doing the activity.
  3. Repeating Oneself? Has your parent started repeating questions or stories more than he used to?
  4. Difficulty Learning to Use Something New? Common examples include having trouble with a new kitchen appliance or gadget. This can be a tricky one to decide on, given that gadgets become more complicated every year. But if you’ve noticed anything, jot it down.
  5. Forgetting the Year or Month? Especially once one stops working, it can be easy to lose track of the date or day of the week. But if you notice your parent forgetting the year or month, make a note of this.
  6. Difficulty Managing Money and Finances? Common examples include having trouble paying bills on time, struggling to balance the checkbook, or otherwise having more difficulty than one used to have managing finances.
  7. Problems with Appointments and Commitments? If you’ve noticed that your parent is having more trouble keeping track of appointments and plans, make note of this.
  8. Daily Struggles with Memory or Thinking? It’s normal for older adults to take a little longer to remember things, since many brain functions do slow a bit with aging. But it seems that your parent often can’t remember things that happened, or otherwise seems to be more confused with thinking, make note of this.

For more on diagnosing Alzheimer’s and other dementias

  • If you’re worried that your older relative might have dementia, I recommend you learn more here: How We Diagnose Dementia: The Practical Basics to Know
  • My book, “When Your Aging Parent Needs Help“, also comes with worksheets to help you check for signs of dementia, a handy checklist of what information to bring to the doctors, and more.
  • In this Youtube video I share 10 early warning signs of Alzheimer’s Disease that often catch my attention, and what to do if you’ve noticed these warning signs.

  • In this Youtube video, I cover 21 signs and behaviors that families sometimes assume are “normal aging,” but in fact are usually signs of a brain health disorder. It includes the 8 behaviors listed in this article, and many more.

Remember, being proactive usually leads to better results and less stress overall!

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: alzheimer's, dementia, memory

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The material on this site, including any exchanges in the comments section of the blog, is for informational and educational purposes only.

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