Family Input Can Help Detect Dementia Earlier

Recently, USA Today reminded readers of the role that family members play in catching the onset of cognitive mental diseases in seniors, such as dementia and Alzheimer's.  These issues are of particular importance in the legal context because mental issues can affect one's legal capacity.  The ability to conduct estate planning, receive Medicaid, or otherwise make prudent decisions for the future will be made more difficult if begun after dementia or Alzheimer's has set in. By the very nature of the condition, the one who is suffering from these issues has difficultly identifying the problem themselves.  That is why a family plays a crucial role in identifying the cognition problem and addressing it.  As the article notes, "dementia can sneak up on families. Its sufferers are pretty adept at covering lapses early on."  Often it is not until there is some major accident or life-threatening complication that adult children, spouses, and others become fully aware of the problem. To combat the challenges of early detection, experts urge family members to be more involved.  As part of the first "National Alzheimer's Plan," advocates are trying to raise awareness about the need for relatives to be diligent about a senior's actions to ensure mental cognition issues are caught as soon as possible.  One advocate noted, "family input should be mandatory...it's the only way to know if the person really is eating enough and taking her medicines as she claims, and not forgetting to turn off the stove."  In addition, there is a growing call for primary-care doctors to take a more active role in detecting dementia early.  For example, in a regular visit the doctor might ask "How are you doing?"  Usually the senior patient replies, "Fine," and then the matter is dropped.  This minimal discussion of basic life circumstances is too brief for the physician to have any way to ensure that the senior's mental condition has not reached a dangerous level. On top of that, as part of the early detection programs, government officials working on dementia and Alzheimer's issues are trying to get families to conduct advanced planning.  Having a Power of Attorney and Health Care Proxy are crucial as soon as dementia is diagnosed.  No one is fully prepared for the challenges that aging can bring--particularly conditions that attack the mind. No amount of financial preparation or long-term care plans can make the process easy.   However, the overall stress of the situation is less taxing when steps have been taken ahead of time to ensure that sticky matters like estate preparation and proper long-term care planning are decided ahead of time.

Home Care Workers: the Minimum Wage Controversy

Seniors typically obtain peace of mind knowing that they will be able to receive late-in-life care in an ideal setting and that the care will be of top quality.  These simple goals should not be out of reach for any older community member.  However, many seniors will be forced to deal with less than adequate care, often in institutional settings where they would rather not live.

Part of the problem is that many will not have planned for late-in-life care.  Staying in one's home while aging usually requires advance planning and ensuring that a home care worker is actually providing an appropriate level of care. Recently there has been a shortage of quality home care workers.  One of the biggest problems is that for a period these workers were exempt from minimum wage laws.  When Congress passed minimum rights legislation, all home care workers were lumped into the category of exempt employees who acted as "companions."  This was the case even for workers who engaged in a wide range of physical labor helping seniors bathe, dress, use the facilities, walk, get exercise, and eat properly.  Of course, it seems intuitively unfair for these workers to be forced to live in dire poverty at incredibly low wages and no overtime pay.

Fortunately, the legal error was recently corrected.  One reason the law took so long to change was that many of the individuals who fill these roles, often including women and those who are not native English speakers, have few advocates.  Also, as a result of the prolonged period of abysmal pay, advocates are worried that there is a shortage of well-trained, capable home health care workers.  The need for these workers is expected to skyrocket in the coming decades.

The shortage of quality caregivers makes it important for local residents to conduct proper research when deciding on an appropriate home care provider for their loved one.  Therefore, most advocates recommend going through a qualified agency to find these assistants.  Most agencies are required to perform multi-state background checks, screen for drug use, and require references. The risk of abuse or theft is always much higher when home care workers are unsupervised and unaccountable.  Home care is of little value if that home care worker is inadequate.