Posts Tagged ‘eldercare’

Senior Wanders From a Care Facility, Later Found Dead Outside

Wednesday, January 27th, 2010

By Carolyn L. Rosenblatt, RN, BSN, Attorney

Yesterday, there was a news report of another heartbreaking story of an elder who died of exposure after wandering outside a nursing home. She got lost and died in the cold.  How does this happen?  It’s not the first story I’ve read of such a tragic death.  Aren’t the care facilities watching our elders?

The truth is, it’s hard to keep track of elders who get confused and wander.  Care facilities that offer skilled nursing, as this facility did, are supposed to be able to monitor their residents and keep them safe at all times.  Federal and State regulations mandate that safety precautions be taken to protect elders who are known to be confused and unable to protect themselves.  What goes wrong?

I’ve read the citations from our state, hundreds of them, given to nursing care facilities which failed to keep their residents safe and something went terribly wrong. What goes wrong is that in every instance, the facility is violating its own policies and procedures by not paying attention, being distracted, or simply by having incompetent staff.

What can be done about this?  How can we prevent it?  First, the state needs to more carefully monitor and significantly punish facilities that violate safety standards.  A common consequence when the state finds a safety violation is a citation and a small fine to the facility.   Guess that’s not doing the job, is it? Sometimes, these facilities need to be shut down.  Cutting state budgets for enforcement of the rules literally costs lives.

Further, families need to become the safety police.  They need to call their elder every day and visit whenever possible.  I can assure you that the quality of care a nursing home resident gets has a relationship to how often family visits and calls to check on them.  If your elder has a tendency to wander outside, be sure you insist that safety measures are in place, specifically tailored to your aging loved one’s habits and needs.  If you speak up, ask questions and require accountability, your parent or loved one’s chances to stay safe are a lot better.

© 2010, AgingParents.com

Holidays and visiting our aging parents

Monday, December 21st, 2009

Many of us have not seen our parents for much of the year. iStock_000005192329XSmallNow with the holidays upon us, many of us will be spending time with our aging loved ones. Sometimes we find that mom and or dad have begun to show some slipping in their day to day functioning. The direct visual awareness of our parents falling compentencies is often a wake up call to do some planning for the future. Here’s a “heads up” about our own denial:  most of us cope with difficult or unpleasant realities by using denial.  That is, we pretend. We make excuses.  They don’t have a memory loss problem, they’re just tired.  We overlook, ignore, and even use what psychologists call “magical thinking”.  It doesn’t exist.  Our parent isn’t failing in health, they’re just having a bad day.

The visit to parents is an opportunity.  You can see, first hand, how they’re getting along.  You have a chance to bring up any concerns in a gentle and respectful way, after the party is over and when things are a little quieter.  I’m urging our readers to think about a visit as a chance to do some planning ahead while you are face to face with your elders.  Do yourself a favor this holiday season. Take the time to talk about what might happen over time, when most elders need some kind of help.  Sadly, most people wait for a crisis to do any planning, and then, it can be too late to get documents signed, get the information you need to help you with decision-making, and go forward with what you parent wants.  There’s a rule of thumb that you can follow:  if your parent is in his or her 70′s or older, and you’re in your 40′s or older, now’s the time for the talk.

Be sure you ask about where your parents want to age as they possibly need help with everyday activities.  If they say they want to stay at home, as most people prefer, talk about money.  How will they pay for help at home?  Who will provide it?  Are the legal documents in place, such as durable power of attorney and healthcare directive (also called proxy)?  Does your family know who will be in charge of making decisions if your parents are incapacitated?

All this may not feel so festive, but it’s certainly necessary.  It’s a season of peace.  Good information and taking the responsibility to start the conversation about these issues can bring peace of mind to all.

What Price, Denial? Elders losing mental capacity

Monday, December 21st, 2009

What Price, Denial?

Sometimes I am astounded by the situations we encounter as consultants being asked for advice. Elders losing mental capacity and being at risk for financial abuse are recurring themes.

Take this real situation, in a question I recently answered in response to an anonymous person. The location is unknown, but it could be anywhere. It seems that Dad was declared incompetent three years ago. He attends a senior center in his town several days a week. A woman there has been giving him lots of attention and the family is worried. She may not be in the U.S. legally. Her interest seems to come from ulterior motives. Dad has money. He has been financially abused before, and the family is aware of the problem.

The family is worried about what to do because the woman is now persuading Dad to do things with her outside the senior center. They all think she’s after his finances. Here’s the astonishing part: the Dad, incompetent and financially abused in the past more than once, still has access to his checking account and his money market accounts! What are they thinking?

My advice was the obvious: immediately cut off his access to the checking account and money market account. They would need to do this via a durable power of attorney. I am hoping this family had him sign one before he became incompetent. If not, it may be too late. You can’t legally sign documents when you’re incompetent. If they blew it, and never got this done, they have only one choice to protect Dad from a financial predator, and that is guardianship, also called conservatorship. It requires going to court. It’s expensive. It’s a lot of trouble. In Dad’s case, it might be the only thing left that could keep him from financial disaster.

I had a lot of trouble understanding how a family with a Dad in that condition could let him keep using his money freely, knowing he couldn’t make competent decisions. Maybe he has so much money no one cares, but that would be very unusual. It is financial abuse waiting to happen, and it ‘s not the first time.

Is the family in denial about what financial incompetence means? Are they afraid of Dad? Are they all such wimps that they can’t simply step up and take responsibility? I’m not sure, but this is not the first time I have been asked about this, and in a similar situation.

Financial abuse is estimated to cost our elders $2.6 billion per year. We hope that is enough to get everyone’s attention. Here’s what adult children need to know to keep this from happening to you and your loved ones.

1. Have a durable power of attorney signed by your aging parent now, while he/she is still competent. If you don’t know how to do this, start with your local Agency on Aging, and ask for a referral to the right help.
2. When Mom/Dad starts to slip mentally, is declared incompetent by a doctor, or otherwise shows signs of being unable to make safe financial decisions, take charge and don’t hesitate. It’s what loving and responsible children do for their aging parents. Use that power of attorney and take over. That’s what the document is for. Protect her or him from being a victim of abuse.
3. If you are reading this when your elder is already incompetent, and wouldn’t know what he’s signing, forget trying to get a power of attorney. It’s no longer legal to get a signature on something an elder can’t understand anymore. You have to see an attorney and get a guardianship/conservatorship.

If writing this saves one single person from being ripped off, I would be very happy. I am urging everyone with aging loved ones to take a hard look at your own parents. Your denial or theirs about their vulnerability carries too high a price.

To get more specifics about what to do if your parent is not able to handle finances anymore, see the short booklet, How to Handle Money for Aging Loved Ones, part of The Boomer’s Guide to Aging Parents, available at AgingParents.com or on Amazon.
© 2009, AgingParents.com