Because We Care
Practical tips for family caregivers

Tips for vacationing without Mom

We all need time away from constant responsibility. Sometimes the best way to care for your loved one is to take an extended break and recharge your batteries.

If your relative is fairly independent, consider these other services that may be helpful:

• A daily check-in call from a friend or nearby relative. Or from a telephone visiting service
• A personal medical alert system (a single-button pendant for summoning emergency help)
• Temporary meal delivery

Also ensure that all bills are up to date or prepaid and that adequate supplies of medications are on hand.

In case of emergency, leave complete information about your relative’s medical insurance, health history, current prescriptions, and doctor and pharmacist contacts. Include a completed advance care directive and instructions about how to reach you or other next of kin.

If your loved one needs lots of help, plan well in advance for care. Options to consider:

• Family members. Whenever possible, ask siblings several months to a year ahead of time. They may need the notice to make arrangements at work. If they live out of town, have them come early so you can orient them to the routines. This is especially important if your relative has memory problems. Familiar routines will help keep your loved one calm.
• Agencies. Allow yourself at least three months’ lead time if you need to hire in-home care. Use the agency for a trial period as training before you go.
• Facilities. Similarly, if you need to find a facility for short-term residential care, start looking three months ahead. Consider taking your relative to the facility for lunch several times before you leave. Your loved one will come to feel more comfortable. Plus, this will keep you top of mind with the staff and administration as they strive to match short-term requests with upcoming vacancies.
• A care manager. Ask about “vacation packages.” A care manager can find and hire care and provide ongoing supervision while you’re away.

What is mild cognitive impairment?

“Senior moments” are a normal part of aging. They happen to everyone. We just don’t process things as quickly as we did in younger years.

Some people develop significant memory and thinking problems, however, and are eventually unable to live safely on their own. These people have conditions that bring on a full-fledged dementia, such as Alzheimer’s or Parkinson’s disease.

And some people function at a level in between. They can live independently and lead normal lives. But they just aren’t thinking as well as they used to. These people may have mild cognitive impairment (MCI).

Signs of MCI include greater than usual difficulty with

• remembering recent events or scheduled appointments,
• following the thread of a conversation or movie,
• making decisions or following instructions,
• finding familiar locations, or
• making well-reasoned choices.

About half the people diagnosed with MCI go on to develop Alzheimer’s disease or some other form of dementia, typically within five years. Others simply stay at this mild level of memory loss. Some even improve over time!

If you think your loved one may have MCI, schedule an appointment for a full medical exam. It may be MCI, or it could be as simple as a medication side effect or even sleep apnea or alcohol overuse. Follow up every six months to track changes.

If your relative has MCI, there is no treatment, per se. There are, however, things she or he can do to stack the deck in favor of good brain function:

• Increase physical activity. Exercise helps keep the heart and circulatory system strong, which is essential to brain health.
• Increase social and mental activity. People who are socially engaged or who have a hobby tend to keep their mental functions longer. Passive activities, such as watching TV, aren’t as helpful.
• Manage blood pressure. Not too high (risks for stroke). Not too low (results in foggy thinking).

When your relative has money questions

Is Dad asking if he should sell the house now that Mom is gone? Or perhaps Aunt Mary is anxious about her stock investments.

Even if you are good at managing your own money, helping a relative make financial decisions can bring a lot of pressure. Consider hiring a professional to advise you.

• A financial counselor helps with budgeting and projecting expenses into the future. They can also help with setting financial goals, managing debt, understanding credit reports, and getting help from public assistance agencies. They don’t give out investing advice unless they are also licensed as a financial or investment advisor. Low- and middle-income individuals who don’t have investments much beyond their home can benefit from the services of a financial counselor.
• A financial or investment planner recommends strategies for maximum earnings on stock portfolios, gold and other assets.

Ask your friends for the names of financial services specialists they would recommend.

Interview several candidates, in person. Ask about

• experience and education. How long have they been in the advising business? (Aim for at least three years.) What kind of training did they receive?
• typical client. What kinds of clients do they work with routinely? You are looking for someone who specializes in working with older adults.
• payment. Are they paid an hourly fee for services? Or do they get a commission based on selling investments to you? Or perhaps a fee based on how much money they manage for you? Typically, those who take a percentage require a minimum size of account. An hourly-based fee usually indicates a willingness to handle smaller investments.
• certification. Ask about their education and certification credentials.
  • Association for Financial Counseling & Planning Education (AFCPE), for general financial counseling.
  • National Association of Personal Financial Advisors (NAPFA). These are fee-only investment professionals.
  • Certified Financial Planner Board. Certified financial planners often charge based on a percentage of the assets they manage.
• regulatory oversight. For those who handle investments, you want to look up whether there have been any complaints lodged against them:
  • the Financial Industry Regulatory Authority (FINRA)
  • the S. Securities and Exchange Commission (SEC)

Ask yourself how comfortable you are with the person. Does he or she explain concepts patiently and in terms you can understand? The last thing you want is someone who snows you with jargon and numbers.

Finally, consider having an elderlaw attorney check any recommendations. There may be tax implications. In addition, decisions made now could unknowingly affect eligibility for Medicaid and other long-term care options.