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Josephine Part I&II :older_woman::skin-tone-2:, In CT on average a…
Josephine Part I&II :older_woman::skin-tone-2:
Support Options for Caregivers
Therapy
Family
Josephine Transition
Concurrent psychiatric treatment
Antidepressants possibly
Support Groups
Live Well CT
Alzheimer's Association
Caregiver and Family education programs such as 10 Warning Signs, Understanding Alzheimer's and Dementia, and Effective Communication Strategies
Hotline: 1 800-272-3900
www.alz.org
Early Onset, Caregiver, and groups for Josephine
Brain Get Your Mind Moving Program
There are respite care options available for caregivers where they can get a break from the daily routine of taking care of their loved ones. Source:
https://agewellct.org/caregiver-center/caring-for-yourself/
Also available through LiveWell CT cost free and offers both full and half day adult day services, as well as transportation around a certain radius
Nursing Home Activites
Hobbies
Clubs at Nursing Home
Transportation to Senior Center
Recreation therapy
Opportunities to Travel/Leave
Older People "Make a Wish" Non-Profits
Wish of a Lifetime
My Jump: Bucketlist fulfillment organization
Second Wind
Also offers resources for families to understand better the challenges of living with Dementia
Out-Trip availability
Schedule time with daughters to take her out
Art Therapy
Music Therapy
Process of Deciding a Nursing Home vs Other Care Facilities
Continuing Care Retirement Communities
There is access to multiple levels of care within one facility. Patient can "age in place" and add services as needed.
Life Care CCRCS: "Buy-in" based on size, initial services needed + Rental fees
Rental Options: Just Monthly fee
talk to Josephine about her preferences and her options
Support Systems/Conversations with Family Members Regarding Concerns
longer visits with doctor
When having the conversation with the patient is important to keep the following in mind... offer encouragement using verbal and non-verbal mannerisms, listen to what the patient is saying, ask the patient to repeat themselves or rephrase what they said in your own words to ensure that the message they intended on conveying is in fact accurate. It is extremely important to allot enough time to have this conversation, be patient, do not interrupt, do not try and help them find a word if they are struggling. These are all recommend tips given by the Alzheimer's Society (
https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/tips-for-communicating-dementia
)
Discuss changing care to a Geriatrician
family social worker
patient resources at each visit
Cognition Issues
MMSE/Functional Testing Requirements: how can we detect/measure this
Several aspects need to be analyzed when determining the functional performance level of an elderly patient including: gait tests, strength tests, fall risk assessments, balance tests, aerobic tests, mobility tests, sensory integration tests, and much more. An MMSE, while helpful, seems to not be recommended to be used as the exclusive rule in/rule out test. Source:
https://pogoe.org/sites/default/files/geriatric_functional_assessment_module.pdf
driving assessment screening tool
Connecticut has no special testing requirements or restrictions to elderly drivers, although it allows anyone age 65 or older to renew his/her license for a two-year period, rather than the usually 6 year period. The law also allows, but does not require, certain medical professionals to report to DMV the name, age, and address of anyone they find to have health problems that will significantly affect his or her ability to drive safely.
https://www.cga.ct.gov/2012/rpt/2012-R-0521.htm
McLean's Driving Assessment Program
:
Physicians are responsible for making a referral - a prescription for a "driving evaluation" is needed
the assessment normally takes ~3 hours and includes an on-road assessment
McLean does NOT send a report to the DMV. The results of the client's driving assessment are shared with them and their family at the end of the 3-hour assessment, including any recommendations. The report is sent only to the referring physician, unless otherwise requested by the client/family
https://mcleancare.org/wp-content/uploads/2021/02/Frequently-Asked-Questions-re.pd
You need to also figure out what the potential additional costs would be; one source mentioned $200 to $400 (Source:
https://exchange.aaa.com/safety/senior-driver-safety-mobility/evaluate-your-driving-ability/
)
Physicians can notify DMV of a patient's inability to drive, but this is not enforced
BEERs Criteria Medication
Lists medications that are potentially inappropriate for older adults (especially with certain medical conditions)
Avoid harmful drug-drug interactions
Potential need to dose medications differently depending on renal function
cognitive activities at the nursing home
Mimicking Depression
Quite easy to have a similar clinical profile in patients with dementia and patients with early-onset Alzheimer's. Some key hallmarks for depression are as following: reduced pleasure in common/previously exciting activities, withdrawal from social events, tendency to prefer isolation, depressed mood or constantly feeling discourages and helpless, changes in eating patterns, changes in sleeping patterns, changes in affect, increased lethargy/fatigue, suicidal thoughts. With Alzheimer's depressive episodes can be shorter, suicidal thoughts are uncommon, and the general symptoms of depression are much less. Source:
https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048362
mind puzzles and maps
Financial Issues with Aging (Selling Assets, Look-Back Period)
Medicaid Notes
In CT Medicaid covers elders over 65 and for long term care with at home & community based services there are limited slots & waitlists
Connecticut Home Care Program for Elders (CHCPE)
Individual cannot have more than $1600 in countable assets to be qualify for Medicaid to cover a nursing home
start online business with skills
educate patient's on scams
The period is usually 60 months from when the Medicaid application is submitted
Further penalty period aspects: This penalty is a period of time which the person transferring the assets will be ineligible for Medicaid. The Penalty period is determined by the dividing the amount transferred by what Medicaid determines to be the average private pay cost of a nursing home in your state.
Example:
If you live in a state where the average monthly cost of care has been determined to be $5,000, and you give away property worth $100,000, you will be ineligible for benefits for 20 months ($100,000 / $5,000 = 20).
https://www.elderlawanswers.com/medicaids-asset-transfer-rules-12015
In CT on average a nursing home costs about $357 per day for semiprivate room or about $130,000 per year