Memory Care Planning

Allow us to begin the conversation with you with regards to cognitive decline. It is our honor to come in and sit or walk with you and plan what you would like for care to look like for yourself or your loved one during the years of advanced disease progression. We are committed to walking this journey with you. 

Cognitive Assessment and Care Planning

Care planning for individuals living with dementia and/or other cognitive disorders is an ongoing process and a formal update to care plan should occur at least once per year or when indicated by disease progression. 

• Ensuring patients receive the most benefit from treatment options at the earliest point possible 
• More time to plan for the future
• Lessened anxieties about the unknown
• Increased chances of participating in clinical studies, helping advance research
• An opportunity to participate in decisions about care, transportation, living options, financial and legal matters
• Time to develop a relationship with doctors and care partners
• Access to care and support services, making it easier for them and their family to manage the changes that come with the disease  (Alzheimer's Association)

Conditions such as functional impairment and dementia are common and frequently unrecognized or inadequately addressed in older adults. Identifying and limitations by performing a functional assessment can provide the foundation for developing interventions to be addressed in the life care plan.

Financial/Estate Planning 

https://pbnlaw.com/

https://bishopfiduciary.com/

Advanced Directives 

Autonomy can be expressed, and to some extent be exercised, by the elder through the use of Advance Directives created and signed by the elder under the provisions of the Texas Advance Directives Act of 1999 including a medical power of attorney, advance directive to physicians and family or surrogates and a do-not-resuscitate order. By doing so, the elder can express his intentions and have an assurance that decisions made in his autonomy while having capacity will be maintained and respected when he does not have capacity or when he cannot express his decisions. 

http://www.ensignlaw.com/Ethical%20Issues%20and%20Elderly.html

The Katz Index of Independence in Activities of Daily Living, commonly referred to as the Katz ADL, is the most appropriate instrument to assess functional status as a measurement of the client’s ability to perform activities of daily living  independently. Clinicians typically use the tool to assess function and detect problems in performing activities of daily living and to plan care accordingly. The Index ranks adequacy of performance in the six functions of bathing, dressing, toileting, transferring, continence, and feeding. Clients are scored yes/no for independence in each of the six functions. A score of 6 indicates full function, 4 indicates moderate impairment, and 2 or less indicates severe functional impairment.

Activities of Daily Living (ADLs) are the basic self-care tasks that we    initially learn as young children. They are sometimes referred to as “Basic    Activities of Daily Living” (BADLs). They Include: 

• Walking, or otherwise getting around the home or outside. The technical term for this is “ambulating.”
• Feeding, as in being able to get food from a plate into one’s mouth.
• Dressing and grooming, as in selecting clothes, putting them on, and adequately managing one’s personal appearance.
• Toileting, which means getting to and from the toilet, using it appropriately, and cleaning oneself.
• Bathing, which means washing one’s face and body in the bath or shower.
• Transferring, which means being able to move from one body position to another. This includes being able to move from a bed to a chair, or into a wheelchair. This can also include the ability to stand up from a bed or chair in order to grasp a walker or other assistive device.

If a person is not fully independent with ADLs, then we usually include some   information about the amount of assistance they require. For each ADL, people can vary from needing just a little help (such as a reminder or “stand-by assist”) to full dependency, which requires others to do the task for them (ADLs were originally defined in the 1950s by a geriatrician named Sidney Katz, who was trying to define what it might look like for a person to recover to independence after a disabling event such as a stroke or hip fracture. So these measures are sometimes called the “Katz Index of Independence in Activities of Daily Living”).

Instrumental Activities of Daily Living (IADLs) are the self-care tasks we   usually learn as teenagers. They require more complex thinking skills, including organizational skills. They include: 

• Managing finances, such as paying bills and managing financial assets.
• Managing transportation, either via driving or by organizing other means of transport.
• Shopping and meal preparation. This covers everything required to get a meal on the table. It also covers shopping for clothing and other items  required for daily life.
• Housecleaning and home maintenance. This means cleaning kitchens after eating, keeping one’s living space reasonably clean and tidy, and keeping up with home maintenance.
• Managing communication, such as the telephone and mail.
• Managing medications, which covers obtaining medications and taking them as directed.

Because managing IADLs requires a fair amount of cognitive skill, it’s common for IADLs to be affected when an older person is having difficulty with memory or thinking. For those older adults who develop Alzheimer’s disease or a related dementia, IADLs will usually be affected before ADLs are. (IADLs were defined about ten years after ADLs, by a psychologist named M.P. Lawton. Dr. Lawton felt there were more skills required to maintain independence than were listed on the original Katz ADL index, and hence created the “Lawton Instrumental Activities of Daily Living Scale.”