How to assist those with early stage dementia or mild cognitive impairment to make decisions
https://www.kathysconsulting.com/
dementia decisions
Sun, Aug 20, 2023 4:30PM • 10:02
SUMMARY KEYWORDS
decision, dementia, family members, caregivers, cancel, people, give, money, cons, perfect logical sense, geriatric nurse, person, conversation, solar panels, judgment, impaired, impairs, understand, choices, agree
SPEAKERS
Katherine Cocks
Katherine Cocks00:02
Hi, my name is Kathy. I've been a geriatric nurse for over 10 years. Many times when I would meet with family members of aged loved ones, they didn't always know what to do. I started this podcast knowledge for caregivers, to assist them with practical suggestions as they assist their own loved ones age with dignity and grace.
Katherine Cocks00:24
Thank you for listening, and welcome back to knowledge for caregivers. Today, what I want to talk about is individuals who have dementia, and trying to help them make decisions. What I'm really talking about is that early stage of dementia, or some people may not have quite been diagnosed. But you may have heard the term mild cognitive impairment. And this is a forgetfulness that goes beyond just normal aging. So there's a little bit of forgetfulness as we all get older, and that's normal. But when it starts impairing a person's ability to say manage their checkbook, or it impairs their judgment, that's when it's starting to become more of a mental decline. Making decisions as an adult is a very complex process. Some decisions, of course, are easy. Am I going to get up in the morning, brush my teeth and go to work? Yes, I'm going to do all those things. Some decisions are much more complex. For instance, my husband and I were recently debating back and forth about getting solar panels. And there were lots of pros and cons of whether we should do it or not do it. And that was something that we took weeks to really talk about, because that was a very complex decision. It affects our house, how we're going to sell our house down the road, all different kinds of things. Will they work? Will they last? There's all kinds of questions about solar panels. So it's not a simple decision.
Katherine Cocks02:19
One of the problems I see is that a person who has just the beginning of dementia are already some memory problems is that many times family members do not understand that their judgment is greatly impaired. I will have the children often tell me. I don't understand. I sat down I had this conversation with my dad. This makes perfect logical sense. And I don't know why he won't agree to this decision that we want him to do or something like that. Well, the problem is his judgment is impaired, he does not see what you see, there are other people who don't have impaired judgment. And they still don't want to make the same decision that their children or family members want to make. But it's doubly hard when somebody has these early stages of dementia. I took care of a lady for instance, she had decided she was going to move into an independent living community. She had to pay down a fairly large amount of downpayment or something like $5,000. And she would get that back if she cancelled within 30 days. And then I don't really know the rest of the process. Well, she was already having the beginning stages of dementia, she decided to cancel at day 34 Or something like that she had signed a contract that she had 30 days to cancel to get her deposit back. And if she didn't, she wasn't going to get it back. She still moved out did not get her deposit back. But she couldn't process that she had done anything wrong or that she had made a mistake. But in her mind, God was going to give her back that money. So she was always entering see sweepstakes and drawings, all kinds of things. Some of them involve money. That's when the children had to kind of step in and go, Okay, we're going to give her a little bit of money, but we're going to manage the money.
Katherine Cocks04:23
A lot of people will do that when it comes to things like assets and money because they don't want their family member who's beginning to have some memory loss to get scammed or to spend their money in a reckless manner when they need that money for their care. The problem comes in I see with many family members is that they really want to include the person with dementia in the decision making process. Now, I applaud them. I understand that they don't want to just come and lay down the law and saying Mom and Dad, you've got to do this because this is the best decision for you. The problem is when we are trying to give them the pros and the cons of a decision, or when we are trying to lay out, you know, five or six rational steps or reasons that we need to make a decision or go a different direction. They may just not be able to process that. And it's so hard for us to understand because we can have a conversation with them. And it seems like we're having a normal conversation. But their brain just cannot process complicated, or decisions that involve, you know, more than two or three pros, cons, different variables.
Katherine Cocks05:49
I get called into this situation many times. It's always very uncomfortable for me, because I'm sitting there, and the child mom, remember we talked about we're gonna bring help into the home? And mom go, I didn't I don't need any help. I'm 95 years old, I've always been taking care of myself. Right? And then the daughter is like, Okay, well, we talked about this. If it's anything like my husband, he talks to me about a lot of things. And then just because I didn't say anything, he thinks that I've agreed with his decision. So I've had to say, Wait a second, let's wait a while for I agree with your decision.
Katherine Cocks06:30
Also, because of their processing, and their inability to really read nuances, we need to be careful how we say things to these people that are in these early stages, because sometimes they are still living at home by themselves. And we need to be careful how we approach things, right? People often call us like, Hey, we're going to bring some help in the home or caregiver is going to come in the home help already the person is feeling helpless by those words. So a lot of times I tell people, sometimes you have to kind of come in there and be like, Dad, I'm coming over every day after work, I've got my own family, there's a couple days, I'm not gonna be able to come but we've got somebody that's going to come in and help you get dinner ready. Rather than somebody that's a helper, you know, somebody is going to come in and prepare your dinner, say in a different way, try to avoid the help word. Just somebody's going to do something when I can't be here. Instead of bringing somebody in and trying to have a long drawn out conversation and get them to agree to something.
Katherine Cocks07:42
Now, if they don't let us in, we can't force ourselves to come in. But just remember this. I know they sound rational. But if they are having memory problems, then they are also going to be having judgment, problems. Judgment of making decisions is going to be the first thing that is really greatly impaired. Read, study, figure out different ways to approach your loved one, but try to keep their choices simple. For instance, if they need to move, where do you want to live? That's huge question so many places. You do the research, to find out and then go time to look at some different alternatives and have them go visit two places and pick one of the two, something like that. We want to give them as many choices as we can. But we don't want to frustrate them or overwhelm them by giving them too many decisions and choices to make. I would love to help you if you have any questions on this. You can reach me at info at kathysconsulting.com I'm passionate to go on this caregiving journey with you to share the knowledge I've learned from the past 11 years working as a geriatric nurse.
Katherine Cocks09:17
I hope you have enjoyed this podcast. If you have found it helpful, then share it. If you wish to contact me for consulting services, you can reach me at www kathysconsulting.com and Kathy's is spelled K A Thys. Remember, all content is meant for informational purposes only, and not to replace the advice of healthcare professionals.