Supporting unmarried 70 yo cousin who has dementia

Nora F

Hello everyone - I am seeking guidance/advice as my family starts on this journey. My nearly 70 year old cousin is showing all the signs of dementia. It runs in her family; in fact her older sister has been in a memory care facility for several years. She never married and has no children.

She understands that she is dealing with some memory loss but doesn't know how impaired she is. The good news is that she is open to getting support from her family. She has given up driving, but doesn't understand why people are bringing her meals.

We have an appointment for her to have a consultation at Swank Memory Care (Delaware), but her appointment isn't until August 12th. She knows that she will eventually have to move and cannot live alone. Right now, we are trying to figure out how to best support her until she is officially diagnosed. 

Some general starter questions:

• Can anyone recommend services they have used where someone can check on a loved one several times a week?
• Does anyone have experience/insight in providing support with financial stuff before she is diagnosed? For example, we can have single serving meals delivered and she can afford it; setting up bill paying with a credit card and then us making sure that the credit card gets set up and paid. All of her concerned family are cousins. We won't have a problem bringing up the issue with her, but it's so difficult getting information because of speech and memory issues.

I'd love any and all suggestions and advice on how we can provide support in the interim before an official diagnosis is made. Thanks in advance.

Nora

M1

Welcome Nora.   You are more than kind to support your cousin and fortunate that she is willing to accept help.

One of you needs to get power of attorney if you don't already have it, both durable (for financial etc.) and for health care.  Starting place is usually with a certified elder law attorney (CELA).  He/she can also help you with assessing the financial situation to determine what needs to be done if she needs Medicaid eligibility in the future.

Good luck.  Read a lot of threads, there is a lot of good informaiton to be had.

Cynbar

It is really important now to get a handle on her finances. She will likely need more care soon, and probably placement sooner than later. You are all cousins and it's wonderful to see you so concerned, but I'm sure you all have busy lives of your own. A person with dementia soon requires a lot of daily assistance and support. most will need involved family close by to provide supervision and "take over" fairly early in the process. Now is the time for you to honestly assess how much you'll be able to do. One person will want to be the financial power of attorney, another might be the medical POA, or it might be the same person (usually an alternate is also appointed in case #1 can't do it.)  A geriatric care manager might be helpful, this is private pay but can help you navigate and develop a plan moving forward. This is a nurse or social worker trained and experienced in elder care, knows the resources and can assess the situation and put the pieces together. You'll find a lot of advice here on how to get your cousin to accept the help she needs, don't hesitate to come here with specific questions.

Jo C.

Hello Nora, and a very warm welcome to you.  Your cousin is blessed to have such a loving family and it is good that you are looking at all of this from a practical standpoint; that will be very helpful for the future. It is also good that this is being done while your cousin is willing and able to do so.  Sometimes as dementia progresses, such matters become much more difficult due to a Loved One's (LOs) resistance or inability to sign legal papers. Since you mention that it is already a bit difficult to get things settled due to your cousin's memory and speech issues - this is a red flag warning - do NOT delay getting to an Elder Law Attorney asap; if this were me, I would find waiting until after the August appointment far too risky as steeper changes can happen quite abruptly and that would place barriers in the way of arranging her legal issues.

First, who does your cousin wish to be her priimary person to make decisions for her if she cannot do so?   She will need to name that primary person and a second, back-up person should the first become temporarily or permaently unable  to perform their duties.  These would be the names placed on the Durable Powers of Attorney for Healthcare as well as one for Finances for conducting her business and making decisions for her in her best interests when she is unable to do so..

The very first thing that should be done would be to make an appointment with a Certified Elder Law Attorney.  This specialty is necessary as there are a myriad of details involved in elder law, especially if dementia is part of the picture.

You will need to gain the advice of the attorney with your cousin while your cousin is still able to sign legal papers; again, I would advise not to delay doing this.  Of importance is not only the legal power to make decisions for her healthcare; but also being able to manage her finances for her; this is no small thing.

When you have the legal paperwork in place, it will all become much smoother and the future will have a frame around it for the present as well as for those future needs as things evolve.  The attorney can also discuss obtaining Guardianship should that need ever arise; but hopefully that will not be necesssary as it is expensive and often time consuming.

The Alzheimer's Assn. has a 365, 24 hour a day Helpline that can be reached at (800) 272-3900.   If you call, ask to be transferred to a Care Consultant.  There are no fees for this service. Consultants are highly educated Social Workers who specialize in dementia.  They are very supportive, wonderful sounding boards, have much inforamtion and can often assist us with our problem solving.

You are on the right path in getting thoughts together as how to approach all of this and taking concrete action to do so..  The assets of your cousin will be taken into consideration by the attorney too.  If she has significant assets there will be not much concern regarding financing future care; but if she has modest assets, then the attorney will want to put safeguards into place for that eventuality if Medicaid ever becomes necessary to pay for her costs of care.

What a lovely caring family; I so wish you the very best.  Please do let us know how you and she are doing and how things ar going; we truly do care.

J.