MC Care Plan meeting tomorrow/Monday afternoon

jen ht

Hi community,

I am seeking feedback on the notes I've made for Dad's Care Plan meeting at his new MC Community tomorrow.

If I am out of line I am inviting you to point this out to me please.

Thanks in advance.

Notes below:

Sometimes it is hard for me to know when it's Alzheimer's talking and when it's really what Dad is needing help with. I am particularly sensitive when someone expresses distress. Could you provide guidance for me on this?

He is still physically active. What activities could we include for him? I hope it might provide an outlet for some of the anxiety. There was a practice golf putting strip he liked and used often at his MC home in Florida. Could I donate one to the community here? 

I had originally thought that I could provide some enrichment or additional activity for him by taking him out for meals or over to our home, etc. He is so upset and focused on not being here, I'm concerned that I won't be able to get him to come back or that being in the car might not be safe for him (either of us, actually). I guess we won’t know until we try maybe? What do I do if I have trouble getting him to come back? Or do you recommend not taking him out at this time?

Could we redirect Dad by asking about his dog (Roxie, the corgi)? or we might brainstorm a list of possible topics to use other than saying that I’m the only one who can sign him out? This seems to bring on more anxiety for him.

Could I get his current meds list for his neuro appt on Wed. please? Any other things you’d like for me to include or ask about during this appointment? *Thinking he might help with agitation meds and ideas, etc.

Emily 123

Hi jen,

I think you'd be on the right track to work with his NP and Neuro to adjust his meds to help with the anxiety. Two moves in a few months will have been a lot for your dad to handle, but you did the right thing in moving him closer to you. Just keep in mind that he'll struggle to imprint anything new, so the frequent calls are because he has no memory of how many other times he's called already, and he'll call often because his new environment will look new to him for quite a while as he slowly settles into a routine.

I would definitely not try to take him out, given your concerns. Get his meds adjusted, let him settle in over a few months and re-assess. I would do visits, understanding that it's ok to take a break from them or slide out early if they seem to get him upset.

Let the facility know that you definitely want dad to be reminded to participate in activities XYZ, and have them list the activities on the care plan. So if there are physical activities you want him to do, like a walking group, get it on there. The care plan is your opportunity to specifically note what you want done. Example: My mom plays solitaire on her ipad for hours, and so her care plan includes the ipad charge being checked at shift change.

Absolutely talk it out with them about how it's agitating him when they make it seem like his being there is dependent on you. I'm sure they can work with you to come up with something.

M1

Hi Jen. It occurs to me that taking him out to doctors appointments may also be very problematic right through this juncture. Does he really need a neurologist? I would ask about access to docs who work with the facility such that his meds can be adjusted without having to leave the facility. Or alternatively i would delay any outside appointments if you can.

harshedbuzz

@jen ht

Many MCFs have a set schedule of activities that may already be available to your dad. Dad's had something going on from 8am until 9pm with only a siesta after lunch— games, crafts, music presentations, exercise classes, container gardening, cooking. They already had a putting green game, so if your dad's doesn't, they'd probably be happy to have one. Ask. Let them know what he might enjoy and ask them to escort him; dad's DON used to write him an individual invitation to music performances.

Some MCFs have outings for those who are up for it. Both dad's and auntie's did a weekly lunch out somewhere and sometimes an added trip to a park, dollar store or small museum. Once he's settled, this might be an option.

I would not take him out or back to your home until he's settled. We chose a place where dad could get most of his medical care in-house (PCP, geripsych and podiatrist came regularly as well as phlebotomy, X-ray, PT, OT and ST as needed), but we still needed to take him to the urologist for twice yearly ADT shots. For that we hired medical transport rather than drive him ourselves.

Good luck.

HB

jen ht

https://alzconnected.org/discussion/comment/215878#Comment_215878

Thank you, Emily.

I just couldn't get a peace about taking him out with me. You've confirmed for me what my gut was trying to tell me. Thank you.

I think my request to not say that I am the only one who can "get him out" landed well. We shall see. crosses fingers

Thanks again,

jen

jen ht

Okay, @M1… I so needed this truth. Thank you. I've postponed it for now.

Also - thinking of you so much.

jen ht

@harshedbuzz

Right! Yes, this set calendar of activities was something I was really looking forward to for Dad. I think he kind of "surprised" this particular community. I'm not sure they were ready for a resident like him. Their current activities are very mellow and limited in length and frequency to match the previous residents' needs. With his ramped up anxiety, he's just not in this same peaceful space and doesn't seem to be able to stay engaged. I think as they get to know him and respond to his types of struggles and needs… I think they will create other types of activities that hopefully will hold his attention and increase his participation. There are more women at this time, too, so sometimes the activities just don't pull his interest. I am hopeful, though, after today's meeting that they are working on it.

Today I was able to share the things he participated in at the previous community like sing alongs (he loves these!) and art / painting and the golf putting practice. They are looking into getting a golf activity on loan from the assisted living part of the community.

We're going to delay his appt and when it's rescheduled I will look into medical transport for him. Thank you for this confirmation too.

And I absolutely love the personal invitation the DoN wrote for your dad for the musical performances! :)

M1

Glad it went well Jen.

My partner is very much a loner by temperament and is also claustrophobic and crowd averse, so she has never engaged in the group activities offered. I have come to learn that memory care and really all community living situations are not very attuned to the needs of introverts. She was so unhappy at her first facility that i could rarely visit and only with others, as i would trigger her wanting to leave.. Even though she became more content after i moved her to a larger, more diverse facility, she has never been interested in group activities. I compensated by planning art projects and things we could do during my visits. There is also a resident cat that she loves to visit, a large courtyard where we can sit outside, and a plant room that we made our personal project and puttered in for hours. You may find those kinds of things necessary for your dad as well. If you can find someone suitable, you can also hire an individual companion to entertain him, though of course that comes with additional cost.