Some goal for my two week visit from Minnesota. Other trips will follow. 1.) SENIOR CAREGIVER - Hopefully interviewing a gerontology care giver who works with the client (Mom) medical teams, and our family. 2.) Does Mom need a GERONTOLOGY specialist or is her regular GP fine? 3.) FALLS- what has been documented, what has been ignored, when should she be seen right away (head/face injuries). 4.) FALL ALERT SYSTEMS - I am bringing my fall alert watch and we will charge my alert watch and her pendent each night and wear them when we get up. 5.) ONLINE BANK - help other family set up with customer verification with my Mom's phone. 6.) PHONE: Check spam tests, emails, and calls are blocked. Check who she blocked accidentally and unblock if necessary. Add photos to contacts as a visual reminder in addition to written contact names for when she gets more forgetful and to help us remember/know the people in her life. Add emergency contacts list to her iPhone in addition to her only saying "Seri, call…" for a list of most important calls. Keep the iPhone on my family plan, because she is used to it and I can turn on tracking for her safety. Don't get a Senior Phone for various reasons at this time. 7.) SHOES: what brands do you recommend for someone who has had various falls at home and out and about because she insists on wearing comfortable slippers?. 8.) OT - "senior proof" home, especially for falls. Get rid of dangerous items? 9.) DIETARY LOG - track meals and snacks for effects on diabetes and bowel problems. She doesn't see a correlation, but is a pint of ice cream leading to spiked sugar levels and possibly diarrhea because of lactose intolerance for example. 10.) MEDICARE - what coverage can she get for home health care? 11.) ANYTHING ELSE RECOMMENDED? I have these first two weeks to begin working with her, not against her, hopefully with some cooperation. I will make additional visits as possible from Minnesota to Bronxville. 12.) My mother is more combative and paranoid and believes my sisters, nieces, and I conspiring against her, but is polite and reasonable with friends and others.
A geriatric psychiatrist can be invaluable in management of meds for combativeness and paranoia.
You need to find a Geriatric Care Manager if you are going to do this from afar.
It does not sound like mom should be living alone without live-in care.
Can mom afford assisted living or Memory Care? There is a nice place called The Fountains in Yonkers. It wasn't right for my mom, but suited other family members well.
Is there any thought to moving mom to a facility in Minnesota? It would make emergencies easier and costs are much lower there.
Very important to remember: UTIs in the elderly are often with physical symptoms but can manifest in aggressive and out of character behavior.
Even if she doesn't have a PoA someone will need to try to become joint on those accounts in order to manage her affairs and have insight into what's going on financially (mismanagement, frauds/scams).
Do any of your siblings/family live near your Mom? Even if a niece/nephew/sibling this would be helpful. Establish a contact person (for the short-term): someone like a neighbor, friend, trusted person from her church/synagogue, etc.
Does she still drive?
Does your Mom live in a house or apartment/condo? While on your trip, discretely make a copy of her resident key. If possible hide it outside where it can be found in an urgent situation to gain access. If it's keyless entry, make sure you know the code.
Please understand that any strategy you put in place that requires her to do ANYTHING is likely to fail. She wears inappropriate footwear not because she lacks it but because her reason, logic and therefore judgment is now failing. Will she voluntarily wear the alert system or remember what its for and to use it in an emergency? Even if it's a passive system that requires her to wear a smart watch, she will take it off. My Aunt didn't wear hers. My Mom doesn't even put her hearing aids in even though she "knows" she can't hear well without them.
While in NY, whoever is her PoA must take those documents and submit them to every doctor she sees. If she doesn't have a PoA then ask for the HIPAA Medical Representative form and have your Mom fill in your name and sign it at every doctor she sees. This allows her medical team to *legally* be able to disclose her private medical information with you without further consent or requiring her to be present. They expire after 1 year.
In the end if you are the person who will be managing her affairs and making decisions on her behalf, it may be best to relocate her to MN. I live in the SW metro suburbs of Mpls. My MIL was in an excellent faith-based facility run by Presbyterian Homes. Another good one is run by the Ebenezer Society. They are non-profit and established and have locations all over the state.
Of course this would be a big change for her. Of course she won't like it, but this doesn't mean it isn't the best solution for her optimal care and one that is least onerous to you. You will now need to employ "therapeutic fibs" to get her to comply with anything she resists. She may benefit from medication for her mood and paranoia -- but who will dispense it to her daily? My Mom benefits a lot from a minimum dose of Lexapro, which helped with her paranoia and depression, which is part of ALZ and dementia.
Feel free to PM me if you have any MN-specific questions about care. I feel for you... I had to manage care long-distance for my 2 elderly Aunts in FL for many years. You will need to be flexible and creative so that you don't burn out.
"How much can I reasonably expect to do...?"
There's going to be a lot to do to keep her safe and healthy and it will only increase over time with ALZ. The closer she is to you, the more you can keep things under control.
More information about your Mom's situation would be helpful.
You are bringing a fall alert watch and pendant, with the plan of charging every night. What will she use when you leave again in 2 weeks? Will her fall alert need to be charged daily? That doesn't sound very practical. I think they make fall alert systems to last a long time without charging or battery replacement.
Regarding her banking, I'm not sure what you mean by setting up another family member with customer verification on mom's phone. You need to set up online banking access, if she hasn't already. Know her login credentials, and maybe even change the password if she starts making unusual banking transactions.
Someone else should (with or without POA) be managing her finances and bill paying. She's not going to be able to manage this on her own.
I think a senior phone, like GrandPad or RAZ would be good for her, but I understand your reluctance to change what she's already used to, especially if she relies on voice commands.
For shoes, you could buy great, expensive, sturdy shoes, but if she won't wear them, it is useless. If she prefers comfortable slippers, I buy Minnetonka Moccasins - they are good quality, easy to slip on and off, and comfortable. Make sure she has full foot coverage, not something backless like slides or mules.
If she is able to put socks on easily, and likes wearing socks, she may not even need shoes around the house. Buy some very soft, comfortable socks with anti-slip bottoms. I stay home almost 24 hours a day (caring for my bedridden spouse) and I wear socks around the house all the time. It's very comfortable for me. Just make sure they are not slippery.
YES! A dietary log is a great idea - who will keep it up when you are gone?
Also log bowel movements, medications and sleep habits. If you are taking regular blood sugar and/or blood pressure readings, add those along with the time for everything. You should also note her moods, and activities, just to get a full picture of how her "normal" day looks, and how foods or activities might affect her.
Please resist having a strict food policing policy. Of course, encouraging a healthy diet and avoiding foods which her body responds badly to is somewhat important, but at this stage of her life, it's ok to allow her some latitude in eating what she wants. And it's no use reasoning with her. She can't reason any more.
I don't believe Medicare provides much in the way of home health care coverage. My husband is on a dual-complete Medicare advantage plan, which also includes his Medicaid coverage, since he is eligible. Call the number on her Medicare card to talk with a representative and get more answers.
I hope you are working toward a plan of care for her which includes 24 hour monitoring. She should not be left alone with dementia. She may be ok for now, but as her disease progresses, she will be unsafe without constant supervision.
And, don't expect cooperation. YOU need to make the decisions in her best interest whether she agrees and cooperates or not.