October 30, 2019
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August 14, 2019
First, a bit of background…
During a visit to his parents’ home over the holidays, our client Jack noticed that his dad, Bill, seemed a bit more forgetful than previously. Jack observed a slight change in personality and a significant withdrawal from all the family events that his father would normally embrace. Jack wondered if his dad’s medications were being taken appropriately as he noticed some still in the pill box at the end of the week.
Bill lives in Arizona during the winter and in New England during the summer. After his dad’s return this past spring, Jack contacted me about his concerns and we embarked on a plan.
Among the actions that need to be taken when cognitive issues arise, the first is always up front and honest communication. This doesn’t always result in a positive experience, but it is worth trying.
I suggested that Jack raise his concerns with his parents, to see if they were at all aware of what he noticed. As it turned out, his dad had noticed that his memory was not as sharp, but did not see that as a problem. He dismissed it as simply the result of normal aging.
Jack’s mom, Linda, however, opened up about a series of additional things she had noticed. Having lived with Jack for over 50 years (!), she was well positioned to observe changes. Linda expressed relief at being able to talk about her concerns.
Bill appreciated how concerned his loved ones were about him and agreed to attend a meeting with his primary care physician (Dr. Jay), Linda and Jack.
Prior to the appointment, Jack set up a time to speak by phone with Dr. Jay. He wanted to share his observations as well as those of his mom before the meeting, and asked that one agenda item of the meeting be to address his concerns.
Physicians appreciate this type of pre-communication. It allows them to develop a strategy, and to be efficient and comprehensive in crafting an agenda for an appointment.
Dr. Jay addressed several items that day, but a major topic was the observed cognitive change. She conducted a Mini Mental State Examination (MMSE) that allowed an objective and measurable assessment to occur. The scoring revealed some concerns that she carefully and sensitively discussed with all of them.
From there, she outlined a plan that included the following:
As of this writing, Jack and his parents are still in the process of evaluation. But they are approaching the point of having adequate information to work from. Whatever the final outcome, I am confident that Jack has done all he can to provide the best care for his dad.
First, because he was proactive rather than waiting for a crisis to respond. Not only did he step in when he noticed changes with Bill, he had taken steps a few years earlier to establish a relationship with Dr. Jay.
Second, because he recognized that within his family and among his siblings, he was the one who needed to take on the responsibility for assisting his parents with their healthcare.
Lastly, he understood that as an accountant, navigating the healthcare system and assisting a family member with the appropriate management of cognitive decline was not something he knew much about. He reached out and was open to receiving professional help.
If you have older loved ones in your family for whom you may be responsible, I highly recommend paying close attention to subtle changes in the lives and behavior of these adults.
It is always best to be proactive and tenacious in obtaining appropriate medical evaluations before a crisis ensues.
To read more about diminished capacity, click here.
Dianne Savastano is a Massachusetts-based healthcare professional and frequent keynote speaker for CIBC Private Wealth Management events. Over the course of her 25-year career, Dianne has worked in both the clinical and administrative sides of the healthcare industry and is the founder and principal of Healthassist, a personal healthcare consulting service. This post first appeared on healthassistcorp.com and is reprinted here with her permission. Portions of this post have been edited for consistency with CIBC Private Wealth’s style and usage guidelines.
To subscribe to Dianne's free monthly newsletter, "Healthassist News, a monthly guide to navigating the complexities of healthcare," please visit here.
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