How to Cope with the Early Stages of Dementia
By Emily Martin, Esq.
When a parent or loved one is diagnosed with dementia, the diagnosis is devastating not only for the person who has dementia, but also for their friends and family. Because many types of dementia are degenerative, meaning they will continue to worsen with time, a dementia diagnosis often changes the landscape of family relationships. While Dad may have always handled the finances, if he is diagnosed with Alzheimer’s disease and Mom is unable to learn how to manage their money, a child or other caregiver may need to step in and begin handling these things for them. Or if Mom has always loved to drive to her monthly hairdresser appointments and weekly grocery store trips but suddenly finds herself getting lost on the two-mile drive there, it may be time for her to stop driving. How can you tell whether a loved one is suffering from dementia in the first place, and what can you do to help someone who is suffering from the early stages of this disease?
If you suspect that your loved one may suffer from dementia, the first step is to take them to the doctor to get that diagnosis confirmed. The doctor can help develop a treatment plan based on your loved one’s specific medical diagnosis, and having a specifically tailored plan can often slow the progression of the disease. This diagnosis, although difficult to hear, may also help your loved one realize that they need help (at least in the beginning stages of the disease). Although Mom may seem perfectly capable of handling her finances, research has shown that the judgment needed to make financial decisions is impaired even during the early stages of dementia. Even if Mom looks and feels fine and is acting relatively normal, her state of impaired judgment may not allow her to see that something is a scam. Something that she would have easily recognized as a rip-off before her diagnosis may now seem like a good idea to her. Armed with the knowledge of her diagnosis, Mom and her family members will be better equipped to handle these types of situations.
Not only can this impaired judgment make someone vulnerable to abuse from outside parties, but it can also make it easier for unscrupulous family members to prey upon those with dementia. If Dad needs help writing checks and a dishonest family member offers to “take care” of everything for him, Dad might agree to that in a moment of weakness. The same is true of personal decisions, such as whether to move into a nursing home or with another family member. Often these types of situations result in an abuse of power and financial exploitation or elder abuse by family members. Although it is illegal, cases of financial exploitation can be extremely difficult to prosecute. In fact, thousands of cases of financial exploitation of seniors each year go unreported or are not investigated. For these reasons, it is important to make sure that your parent has a strong estate plan in place that is designed to prevent issues from arising when he/she no longer has the capacity to make his/her own decisions.
It is vital that this step be taken as soon as possible – if you wait until your loved one no longer has the capacity to sign legal documents, it may become necessary for a judge to appoint a guardian and conservator to make those decisions for them. When someone does not have a power of attorney, anyone can petition a judge to be appointed conservator for them, so they can manage their finances. In contrast, a financial power of attorney allows you to decide who will make financial decisions for you, and it can also set the stage for Medicaid planning in the future if that becomes necessary. An experienced elder law attorney will draft a financial power of attorney that will give your agent the authority to rearrange your assets and manage them in a way that will allow you to qualify for Medicaid in the future if you need that benefit to cover the cost of long-term care.
Additionally, if someone does not have a healthcare power of attorney, anyone can petition a judge to become guardian over that person, so they can make their personal decisions for them. These decisions include whether they should live in a nursing home, what their course of medical treatment should be, and much more. Not only is this an expensive and public process, but the person the judge appoints may not have been the same person that your loved one would have wanted managing his affairs, if he/she had been able to make that decision on his/her own. In contrast, an advance medical directive often includes a living will as well as a healthcare power of attorney. A living will allows you to state your wishes for end-of-life care. If you were in a terminal state with no hope of recovery, would you want to be kept alive artificially through a ventilator, respirator, or feeding tube? This document helps make your wishes clear to your doctors as well as your loved ones.
If a loved one has recently been diagnosed with dementia, it is important that they consult an experienced elder law attorney as soon as possible in order to get their affairs in order. Most people in the early stages of dementia have the capacity to sign legal documents, but that can change very quickly as the disease progresses. Do not wait until it is too late to have these important discussions with your loved ones.
Ask Kit Kat: Brave Canine
Hook Law Center: Kit Kat, what can you tell us about the dog in Thailand who ended up seeking refuge on an oil rig that is 135 miles from shore?
Kit Kat: Well, this truly is a remarkable story! Somehow a brown dog, resembling a hound to me, but which was identified as an aspin, a breed from the Philippines, ended up near an oil rig, which was 135 miles from the nearest shore off the southern coast of Thailand. No one is sure how he got there. He may have fallen off a ship; nonetheless, he made his way to an oil rig in the middle of the ocean. Fortunately, he was spotted by one of the workers, Vitisak Payalaw, because the water was extremely rough. At first, Payalaw tried extending a pole, but that really doesn’t work for a dog with only front paws to grip it. So, with the assistance of 3 others, a rope loop was devised after some discussion about what was the best way to proceed. The crew was ecstatic when the device worked. Payalaw said, “His eyes were so sad. He just kept looking up just like he wanted to say, ‘Please help me.’ At that moment, whoever saw this, they would just have to help.” Once rescued, they fed him some water and meat. They also named him “Boonrod,” which means “he has done good karma and that helps him survive.”
On April 15, 2019, Boonrod was transported back to the mainland (Songkhla, Thailand) where he was examined by a veterinarian. He appears to be in good condition. He will stay in Thailand a while to regain his strength. Payalaw has volunteered to adopt him, if he is not claimed by anyone in the near future. This is one lucky dog, who never gave up trying! His story could have ended tragically, but perhaps he does have good karma and deserves to have a few more days on this earth. (Kyle Swenson, “ ‘His eyes were so sad’: Oil rig crew rescues a dog swimming 135 miles off Thailand,” The Washington Post, Morning Mix section, April 17, 2019)