Part of being fully health literate is understanding the aging process. Whether you are in your 80's and leading your family through the end of your life, in your 60's and learning about retirement, in your 50's and stuck in the sandwich generation, or in your 20's and watching your parents and grandparents try to navigate the aging process, this is a process that is often fraught with heavy disagreements, guilt,and independence vs safety issues. Yet there is also a very clear process.
Depending on how one has taken care of themselves earlier in life, somewhere between 60 and 70, aging begins to take it's toll. Vision and response times slow, hearing begins to deteriorate, muscles lose mass faster than the best weightlifters can add it back. Slowly but surely, seniors begin to need a little help with small things. Chronic health problems, multiple medications, and long standing family discord can make the entire journey even more unpleasant. Add dementia in any of it's forms to the mix and the result can be absolute chaos.
So how does someone deal with all of this? By trying to remember that everyone is doing their best. By opening lines of communication as early as possible. By showing respect while keeping safety the ultimate priority.
So let's take a quick look at some questions you will eventually need to answer when dealing with a loved one who has been diagnosed with dementia.
1. How do the children really judge the daily safety of a parent who has dementia and still lives alone or with their spouse.
~~Are they taking their medication correctly?
~~Are they likely to forget something on the stove and risk causing a fire?
~~Can they really safely drive? (How many fender benders are allowed before one takes away their driving privileges?)
2. At what point in your family does safety for others and your loved one top the need for independence? Every family has different values in this area (think child rearing), but at some point in the dementia process, safety must top independence.
~~When do you look at home care support or a great out of home day program (with locked doors for wandering protection)?
~~How do you keep your loved one safe when you are away from home?
3. When is it time to move the loved one out of their house? And to where?The dementia diagnosis of any form will keep your loved one out of most
senior housing options, as they are not equipped to deal safely and
securely with the sudden changes that can occur.
~~Child's or grandchild's house?
~~A memory care center? A high security nursing facility?
4. And then maybe the toughest questions of all.
~~Do you ask them to sign a DNR when they are still competent enough to do so. (It's not legal once a certain level of dementia is noted in the medical files, a level that varies from state to state.)
~~Do you treat medical conditions like cancer or mental health conditions like bipolar disorder when the treatments can make the dementia worse?
These are tough decisions. Every family is going to answer them different. But if you can talk the questions out early in the journey, you can simply rely on the fact that you already decided what to do in the calm, when the storms of life make the answers necessary. As a country, we are aging. More and more families are facing these tough decisions every day. And ignoring the problems now, do not make them better later. This I know from personal experience. My mom has dementia. We have had to move her into my home, and then slowly lock it down and make it safer for her. Some days she is so weak, she needs a walker to balance. Some days, she wanders away. Someone in my house is always on Grandma duty. But my family isn't fighting with each other over her care. We know what our family lines are that make it unsafe for her to live with us and we have already been looking at options. Because we love her, dementia and all.
