The internet is filled with endless information about a person with diminished capacity, dementia, Alzheimer’s disease, Parkinsonian dementia; the tell take signs, the do’s, and don’ts and so on. Books, booklets, pamphlets are dedicated to this disease. However, very little is written from the perspective of the actual person struggling with the disease itself. What does that look like? How do we help that person have “the conversation?”
My client is 77 years old. She is a clinical psychologist and is on staff at one of the most prestigious teaching institutions in the world. She has been in private practice for close to 50-years and has helped countless numbers of patients with all kinds of challenges including the issue of coping with dementia. Now she finds herself the patient learning to cope with having dementia of the Alzheimer’s type. She struggles with anxiety daily as she attempts to recall words and phrases, maintain a day to day routine that is familiar, keep up with friends and colleagues, maintain her social calendar and most important, stay in control of her finances as she has always done.
She requests her statements from her Financial Adviser. After all, she has always worked very closely with him and this has been a normal part of her routine. The statements are delivered to her apartment for her review. I happened to be there when the package arrived. She looks through the documents and quickly becomes anxious. She knows she does not understand any of it. She becomes frantic. I looked at her and very quietly asked her the following question, “What are you the most afraid of?” She looked at me with relief in her eyes and simply stated, “I am afraid I will no longer be able to manage my money and other people will take advantage of me.” She paused and then said, “I don’t want people to think I am crazy.”
Luckily provisions have been made so that she cannot be exploited by anyone. However, she does not always recall that fact nor can she always process what that means because her executive function is compromised.
It is critical to understand how people feel about the changes happening in their lives. It is critical to imagine what it feels like to walk in that person’s shoes. I venture to say, it is paramount to the success of the working relationship in the role as a trusted adviser.
1. Are you familiar with the early signs and symptoms of dementia?
2. Do you have the skills to communicate with a client who is exhibiting loss of executive function?
3. Do you know if your client prefers to age-in-place?
4. Do you know if your client is willing to move to an Independent or Assisted Living community if needed?
5. Have you ever spoken with your client about what happens if he or she is diagnosed with dementia?
These are some of the necessary questions and information you must ask or include in your process. Mind you, it is most unlikely any client will come to your office for a meeting and share thoughts of this nature. It is your role as a trusted adviser to be certain your client is heard and his or her concerns are managed.
Jill Poser – Kammet, CGCM, is Director of Life Care Planning at Advocare Care Advocates. Jill is a Certified Geriatric Care Manager by the International Commission on Health Care Certification with 12 years of experience in elder care, care management, life care planning, Medicare home health sales, special needs, and aging-in-place construction. For more information about Jill and how she can help you and your family call (561) 266-3489.