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In-Home Care For My Daddy

 REGINA D. Posvar LPN,RNA
REGINA D. Posvar LPN,RNA

Q: Good day Nurse Posvar. My family and I recently have decided that my daddy needs more care than we can provide and would like to hire persons to help us. We have gathered information from friends and other resources. Because Daddy has Alzheimer’s he has not been the easiest to care for and really doesn’t like others in his home. Some of the family feels he is past this but we are still looking for the right way to approach this. One of our concerns is do we hire from agency or from the hospital? We have received a few recommendations however we have noticed the cost varies. How do other persons pay for the care cost?

A: This is a great question. The cost of caring for a loved one can vary for many different reasons. Finding the right person to care for a person you love has been easy for a few families and a nightmare for others. Having a wonderful family support as you do will help you a lot. A few important keys to consider when deciding on personal care for a loved one no matter the cost:
•The person with dementia is comfortable with the carer
•The family and other help in the home are respected
•The carer themselves feel comfortable in the environment they will be working in.
•Communication on breaks and days off

A great caregiver can come from a family member you hire, agency or someone that was recommended. Family, friends and private recommendations usually will negotiate price that is comfortable for all parties. Cost from agencies are a bit more as the pay usually covers background checks, medical insurance, on call system, vacations and sick leave. They also cover on-going training cost. The challenges with this, you will have more than one person caring for your dad. On the other hand, you will always have someone to help.

From my experience working with families in the homes here in St Lucia or in the States, finding the right caregiver that is trained, trainable and a match for the family has been an ongoing challenge for most families in the beginning. Then keeping them can be a challenge as well. However, it does smooth itself to comfort.

There are a few ways family may cover cost:
•Learn about public benefits in your area and see if you qualify. The NICE programme has helped many families.
•Volunteer programmes are available
•Look into your medical insurance for long-term policies or cash in life insurance. Some private insurance cover care cost.
•Using personal and family assets are what most families use to pay for in-home care cost.
•Some of these can be in combination.

It is wonderful to look into your options. Whatever system you use, keep in mind of your own care needs as well. Just because you hire help doesn’t mean you escape the stress of it all. Managing home care along with other family needs and work is often too much for one person. Family support and others going through similar challenges can help relieve stress.

Q: Dear Regina, I am troubled about my mum with Alzheimer’s. She started having trouble with tremors and we have been to the doctor about it but nothing can be done. I understand but it is not so easy for my mum to understand that we do not allow her to hold the cups of liquid no longer because she spills the liquid on herself. She is angry and fighting us to hold the cup and we try to help her. Someone told us to use a baby cup and we tried and she threw it at us. What can we do to help her?

A: I am impressed with the idea of the baby cup as that is sometimes used. I am amazed at how we improvise here on the island. I would not give up on this idea. Because your mum is not a child she may seem to have felt she is treated such. Use a coffee cup that has a bit of weight on it. People with Alzheimer’s, Parkinson’s and stroke patients have found it to be helpful and do not feel like a child with this method.

From the Fress Quotes ~ “Dementia is often regarded as an embarrassing condition that should be hushed up and not spoken about. But I feel passionately that more needs to be done to raise awareness, which is why I became an ambassador for the Alzheimer’s Society.” » Kevin Whately

Happy Holidays~ Holidays are all different depending on the company and time of your life.
— Dominic Monaghan
Send questions to [email protected] or call/text to 486-4509

44 With Dementia

Q: Good Night Ms.Posvar, Please can you help me? My son has always been a good person. He is only 44. He is not himself and it started last year. And the medication he’s taking is not helping him. Doctors say he has Frontotemporal Dementia. He say it’s Alzheimer’s. His memory not bad but he does so many things that’s not right. This is not my son. He say bad things to people. I want to help him. My family say he is mad and do not want him around.

A: (FTD) Frontotemporal Dementia is not Alzheimer’s; although, the symptoms of FTD towards the end of the disease will be the same as end stage Alzheimer’s. FTD is caused by progressive nerve cell loss in the brain’s frontal lobe or temporal lobes. Early symptoms of this type of dementia are usually behavioural changes that are not characteristic of the person experiencing them.

Most doctors do treat this type of dementia with psychotropic (behavioural management) meds. This approach is not my favourite and often the very last resort and temporary. Working with doctors and families to manage behaviours to reduce medication is the goal. Most doctors I have worked with really want to help. It is vital that families work with the doctor when dealing with medication to manage behaviours. Doctors are not God and need your support and input to help them manage. It is a team effort. Most traditional medication for this type of dementia does not work nor does behavioural medication.

Families will need to be more informed on managing behaviours by understanding what their loved one is experiencing. Often we as family and caregivers provoke the behaviour without realizing it. FTD is one of the few dementias that we have so far that have we not found a provoking cause of behaviour. However, experts do say that most negative behaviours are an unmet need and many times it is an emotional need. So the person with FTD may be experiencing the frustration of not being able to communicate, doesn’t understand why no one understands them; and being unable to express their needs will cause abnormal behaviours that are inappropriate, embarrassing and upsetting to families and caregivers.

I really recommend support groups that understand what you and your son are going through. Learn all you can about this. If your doctor is not supportive then find one that is.
More information about FTD at http://www.alz.org/dementia/fronto-temporal-dementia-ftd-symptoms.asp

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