Ask Dawn at Garden Courte Memory Care

Dear Dawn,

I am starting to see some strange behavior in my dad and he’s becoming very forgetful.  I know we can all forget where we left the car keys, but how can I tell if the memory loss is more serious like Alzheimer’s Disease?  More importantly, what steps should I be taking now to make it easier to deal with in the future?

We often joke about being forgetful and misplacing the car keys or the television remote control.  I know people that even routinely call their own cell phone at home just to track down the ringing sound to locate where it was misplaced.  However with seniors, forgetfulness can be frightening and even dangerous.  Sometimes it may even be signaling a more serious underlying issue, such as Alzheimer’s disease or related dementia. 

Some of the more common warning signs of Alzheimer’s disease or other dementia includes:

• Disorientation to people / place / date / time
• Unable to remember appointments or special occasions
• Decreased or lost appetite, unexpected weight loss or dehydration
• Unable to cook for themselves safely
• Unable to maintain personal grooming / hygiene
• Demonstrating unusual behavior or changes in mood / personality
• Unable to manage their medications safely or take them on schedule
• Wandering from home or unable to return home without assistance

If you know someone that is demonstrating one or more of the aforementioned warning signs, it may be an indication of dementia.  Depending on the scope of the warning signs, there are some very important factors to consider.  First, if at all possible, encourage a professional medical assessment.  This can also help create a baseline to measure over time as the disease progresses.

Next, depending on your relationship with the individual with the possible dementia, identifying potential care solutions prior to a crisis erupting will make it that much easier to implement when needed.  Evaluating services and living options is much easier when not faced with the additional stress and pressure of an emergency decision-making scenario.  It is also wise to begin the estate planning process to ensure documentation is established for items such as a Power of Attorney (POA).  This ensures that when the individual is no longer capable of decision making, the POA can be implemented without requiring the courts and a public guardian, as that can be a very long process.

Finally, there are also support groups in the community to help you cope with the difficulties facing the prospect of a loved one suffering from Alzheimer’s disease or related dementia.  Education about the disease process and a strong support group will be invaluable for dealing with the future inevitable stress of dementia.  There are many viable community options to ensure a high quality of life is maintained.  Identifying those options early in the process is the key to making the most out of this challenging situation.

If you have questions about senior care or helping an elderly loved one, contact Dawn Peterson, Community Marketing Director at Garden Courte Memory Care Community at 360-491-4435 or by e-mail at gardenmkg2@islllc.com.   Garden Courte Memory Care Community is an Assisted Living Community licensed by the Washington Department of Social and Health Services, located at 626 Lilly Road NE, Olympia, WA  98506.  You can also visit Garden Courte online at www.gardencourte.com.

Dear Dawn,

I was just home for the holidays and saw some surprising things with my parents. I think it may be time for me to start looking at getting some help like at an assisted living place. I talk with them all the time, but it seems that with this trip I saw behavior in them that wasn’t normal. Is it just because of the holidays that I noticed this and is this something that other people feel too?

The holidays are often filled with good food, friends and family. It’s during these gatherings when adult children come face to face with the increasing and changing needs of aging parents and family members. Each January following the holiday season, senior living communities see an increase in inquiries from concerned family members looking for help and answers.

The reality of where mom or dad are health wise really hits home for many when they come home for the holidays or simply spend more time with their parents in December. If you are starting to ask the question ‘does mom or dad need help?’ then you know it’s time to at least start inquiring into options.

When a visit home leaves a loved one concerned about the health and quality of life for their aging parent or family member, it is important and alright to follow through, to evaluate the situation thoroughly and determine what accommodations or care are necessary at this time in their lives.

When deciding whether to seek the care of a senior living community, consider these questions and tips regarding the senior in your life:

• EMOTIONS: How are they emotionally? Are there changes in their activity level and mood? Are they seeing friends and partaking in activities they have loved for years? 
• HEALTH: Are they taking their medications correctly? Has there been significant weight loss? Unexplained weight loss could indicate a major health problem. 
• HOME: If you see mold or mildew growing, or insects, take notice. This can become a health concern. What shape is the home in? If the home is in need of repair and un-kept, these can be signs that more help is needed. 
• HYGIENE: Neglecting personal hygiene and cleanliness can be a sign that help is needed. Are they taking care of themselves physically? Look to see if they are keeping up with basic daily routines such as bathing, brushing teeth and wearing clean clothes. 
• MOBILITY: Are they having difficulty moving around their home? Having trouble walking or being unsteady on their feet puts them at risk for falling and injuring themselves. 
• MEMORY: Are you noticing changes in their personality? Memory loss, difficulty in performing familiar tasks, poor judgment, misplacing items, disorientation, rapid mood swings, increased apathy or passiveness are all early warning signs of Alzheimer’s. A doctor’s evaluation can help determine the cause and treatment of these symptoms. 
• MONEY: How are the finances? Any mishandled finances to cause concern? 
• TRANSPORTATION: Do you see any dents in a car? This may indicate erratic or unsafe driving

Dear Dawn,

What is the benefit of moving my dad into an Assisted Living Community instead of hiring in-home care and letting him remain at home? It seems he would prefer to stay at home, so I want to do the right thing – help!

The appeal of staying at home is strong because there is a sense of familiarity and less change. Change can sometimes be overwhelming or frightening for anyone, especially a senior. Moving to an Assisted Living Community can be just as overwhelming due to different surroundings, but the advantages of greater social opportunities often outweigh this concern. Let’s take a look at the pros and cons of both options.

Staying at home with a professional caregiver, your dad will be in his familiar surroundings and he will have minimal change in his daily routine. There are numerous agencies available that specialize in home care, but ensure they are licensed, bonded and do thorough background checks on all their staff. The downside of personal homecare is the potential for staffing issues to arise. If dad’s caregiver calls in sick, your dad might be without assistance for an extended period of time. His socialization opportunities might be limited to only his caregiver and his meal options will be homemade, but likely he’ll be dining alone. The cost of a home care is often more costly than anticipated, reaching thousands of dollars a month in addition to the responsibility of household expenses and maintenance.

The advantages of an Assisted Living Community are by far the camaraderie and socialization opportunities available to your dad. Even if your dad likes his alone time, he has that option to go to his apartment after a game of cards with the guys. Meal preparation is off his hands since most assisted living communities have a dining room, and dining becomes a social event, not just a solitary meal. Mental stimulation at an Assisted Living Community is at its’ peak with multiple interactions with others in his generation and tailored activity programming. Most Assisted Living Communities encourage your dad to bring familiar furniture pieces, art work and any hobby materials with him to make his new home his own. While it may take a few weeks for a senior to adjust into their new surroundings, often the only regret is that they didn’t make the move sooner. And the costs for an Assisted Living Community are generally a lot lower than what you would pay for just homecare. You are doing the right thing for your dad by looking at what options are out there.

Dear Dawn,

I am very concerned about my mother who has been caring for my father with Alzheimer's for many years. I am trying to convince her to get some help, so that something doesn't happen to her...

It is important to know the signs of stress, and ask for help as often as you need it. Warning signs of Caregiver stress are: denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability, lack of concentration, health problems. Ways in reducing caregiver stress would be to get in contact with helpful resources in your community, learn all you can about Alzheimer's disease and care giving techniques, join a support group in your community, get help from family, friends, and your community. Get your loved one involved in an adult daycare program so that you can do something for yourself. Give yourself credit for what you do!

Dear Dawn,

Could you help me understand the difference between a Nursing Home and an Assisted Living Community?  I thought they were the same, but recently I began some research for my parents and am I’m confused how they are different.

There are two key differences between Nursing Homes, or more specifically Skilled Nursing Facilities (SNFs), and Assisted Living Communities, also known as residential care facilities (RCFEs).  The first and most pronounced difference is the setting or environment and the second difference is the level of care provided at each setting.

SNFs are designed for medical necessity with 24-hour licensed nursing care for services that are designed to help transition between the hospital and home.  Typically SNFs are for people requiring temporary rehabilitation therapy services after surgery or injuries and as a medical model of care.  SNFs often care for the very frail and frequently, as medical facilities, SNFs feel very institutional.

Assisted Living, or RCFEs, provide “custodial care” in a residential setting.  Because RCFEs are not a medical model, not only is the environment much more inviting, they are often far less costly.  “Custodial care” is assistance with the routine activities of daily living (ADLs) that one normally does to get up and get started for the day; bathing, dressing, grooming, toileting, housekeeping, meals, and even transportation and medication management.  RCFEs are able to provide fairly advanced levels of assistance with things that are often commonly thought of as medical care, for example, some AL Communities even offer diabetes management. 

The other significant difference between the SNF and the RCFE is a SNF is typically a semi-private room much like a hospital, whereas the RCFE looks more like an apartment building and affords residents a private apartment as well as a full schedule of planned activities, gourmet meals and personal transportation.  Instead of a hospital-like lounge area, assisted living has common areas with couches, fireplaces and gardens.  Instead of a sterile cafeteria, dining areas resemble fine restaurants and often offer entertainment.  RCFEs are often equated to a cruise ship for seniors that’s permanently in port.

SNFs fulfill an important need in the continuum of care for seniors, and while they also offer long-term custodial care, few seniors need to remain in the SNF setting for that service with so many RCFE options.  Not all RCFE residents need care or assistance, and some are there because they just want a simpler lifestyle without the worry of maintaining a home or garden and they want the socialization of their peers. 

Dear Dawn,

I’ve been searching the internet for information and resources about caring for my dad and I’m finding a lot of referral sites that want my personal information first.  It’s frustrating trying to search the internet when I keep getting inundated by services I don’t want.  What I really need at this point is some reliable information.  Can you direct me to a reliable source of senior care information?

First, let me start by stating that the challenge you are encountering is unfortunately a very common problem.  While the internet has become an excellent source of information, it is primarily an outlet for commerce.  Many clever internet businesses give the impression they are there to offer you valuable information, but only after registering or signing up for something with your personal information.  Beware of any internet site that requires you to register first in order to receive the information you are looking for in your search.  There are easier ways to gather the information you seek.

Many referral agencies, senior providers and placement services use the guise of luring consumers with the promise of providing useful information on their internet sites as a means to get contact information.  They often request the consumer provides some basic information before moving to the next screen – for the information that is ultimately sought.  After registering on their site, that consumer is suddenly their “client” for a placement service and their information is sent out to multiple senior providers.  While this won’t cost the consumer anything, it is often a source of aggravation as the providers that received the contact as a “referral” start following up with false requests for information, which in fact may never have been requested.  This is not to say the internet isn’t a potentially valuable source of information, but it can be very time consuming and highly inefficient. 

Find a service provider in your area and visit them personally if you want reliable information that is both relevant to your situation and to your geographical location.  Assisted Living communities are a great starting point, even if that’s not the service you are seeking.  You will be surprised at not only how knowledgeable they will be with the various services and programs in your area, but also how willing they will be to provide you with valuable information.  The management teams at these communities are not only experts in their field, but they network with all the other service providers in the area and know the resources available.  Using your local experts is the most efficient way to seek information on senior services, programs and other useful information.  Besides, how likely is an out-of-state internet provider likely to know the specific resources available in your immediate area?

For more information regarding Alzheimer's/Dementia and community resources contact Dawn Peterson, Community Relations Director, Garden Courte Memory Care Community, 626 Lilly Rd. NE Olympia, WA 98506 360-339-5080, or Email us