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Senior Care Expert: Merret Mann, Gerontologist

Common Questions and Answers

Merret Mann is a gerontologist with a passion for working with elders and their families. She has over 20 years of experience working with seniors in a variety of settings and a strong commitment to quality care. Her entrepreneurial spirit has led her to develop a few businesses including a private duty home health agency, an intergenerational community program, and a personal service company at a resort community. Mann holds a Master's in Gerontology from Naropa University and a Bachelor's in Communications from the University of Colorado. Get answers to common questions she receives about eldercare and senior living below.

Common Questions and Answers:

Q: I'm afraid that my dad has dementia, possibly Alzheimer's. What do I need to know and/or do?

A:  First, take a deep breath.

Then, take your father to his physician for a full check up and talk to his doctor about your concerns. Bring a list of the medications he's taking and note recent changes in his behavior that concersn you. A decline in cognitive functioning does not necessarily mean he has dementia or Alzheimer's disease. Metabolic changes, medication side effects, heart disease and a whole other host of medical issues can result in cognitive issues. Your father's doctor may then refer him to any number of specialists once you understand the status of his current physical health conditions.

Other things to think about:

  1. Gather your support network and discuss your concerns with them. Discuss who can help your father and discuss ways you can work together to get him the care he needs.
  2. Start thinking about your father's safety. Which behavior changes alarm you most? Driving accidents, poor hygiene and volatile conduct often top the list of noticeable behavior changes.
  3. Look at your father's finances and think about getting a Power of Attorney. People with cognitive challenges are at risk of being taking advantage of, and many have difficulties handling their monthly finances. It is not uncommon for dementia patients to pay their bills twice.

Above all, it is important that your father participate in this process as much as possible. The very ground is shifting underneath him. Allow him to maintain as much dignity and independence as possible.

Q: I think my Dad would do so much better if he moved to an assisted living community. Plus, I wouldn't worry as much knowing that he had appropriate care and supervision. The problem is he's resistant to the thought of this change. How do I talk to him?

A: First, you have to consider why your father is being resistant. He doesn't want to leave his familiar home, comforts and freedom, and his view of senior long-term care may not be positive. Fortunately, elder care has come a long way in terms of quality living options, and is only getting better. Shifting his view from this antiquated landscape of what assisted living has been in the past is essential. This is where time is on your side. Start now. The marketing staff at the assisted living communities should be able to offer ideas and reinforcement to help ease your dad into a senior living solution that's right for him.

Unfortunately, there is no denying we come from an ageist culture; one that doesn't remember how to honor the aging process or quite often, the elderly themselves. With this in mind, consider your dad's perception. He might feel minimized, so get into his shoes and position your line of thinking, and the conversation, from his situation. Your dad also wants to maintain his dignity and stay in control of his own destiny, as much as possible. So consider the ways that you can help your loved one feel in control.

  • Let him accompany you when you visit the communities
  • Ask him what's important to him in his new living environment
  • Give him weekly outings to help him maintain his sense of freedom

Lastly, before jumping in, consider whether Dad really needs to make the move into assisted living. For example, if you are concerned that Dad's typical dinner consists of macaroni and cheese and a glass of wine. While this may not be the healthiest lifestyle, it's not necessarily doing significant harm (this is where you should talk to your dad's doctor and provide alternative dinner options). Leaving the stove on, forgetting to take medications and wandering from home are health and safety issues that are among the reasons to consider assisted living.

Q: I was visiting my sister recently and I couldn't believe how many medications she was taking! I think she is acting a bit strange, too, but I can quite tell what is going on because we only see each other twice a year. What do I do?

A:  First, let me say I am a gerontologist, not a doctor and no changes to any routine should be considered without consulting the prescribing physician. That being said, here is what I know on the topic.

Often we have several prescribing doctors and they write scripts without full clarity as to what the patient is currently taking. Polypharmacy means "many drugs" and refers to the problems that can occur when a person is taking:

  • More drugs than they need
  • A bad combination of prescriptions and/or over the counter (OTC) medications and supplements

It is also possible that your sister's strange behavior is caused byinteractions between drugs and foods she is eating. My best recommendation is to have a pharmacist run the medication list through a "drug interactions database." This can help you feel more informed, possibly solve the problem and give you a better grip on the situation.

Here is a short list of actions that I have seen be effective in handling the wide-world of medications:

  1. Avoid "combination" medications and vitamins, or products that claim to treat many symptoms. Talk to your pharmacist to help you find a product just for particular symptoms.
  2. Have one doctor that oversees all of the medications and supplements.
  3. Bring a complete list or the actual pill bottles to all doctor appointments.
  4. Know the diagnosed medications by name and have a clear understanding of what symptoms they treat.

 

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