Dementia? Alzheimers? Intervention??

socal78

Well-known member
No, I'm not referring to Joe Biden.

One of my best friends is 77 years old and I'm concerned. I wanted a place to post this kind of anymously so TI it is. We are nowhere near the same age. We're just an odd match I guess. But it works for me because she's such a nice person. Anyway, she has been rambling non-stop! Also exhibiting some strange behavior. I am concerned it may be not a good sign because I read it's an early symptom of dementia but I don't know what to do about it. Does anyone here have experience with an elderly friend or relative who has dementia? My friend, sadly, lives alone. She never got married or had kids. Her mother and father are dead. Her brother is dead. Her only sister-in-law just died. Her nieces and nephew are her only living relatives but they literally never visit her. They live in Thousand Oaks and one lives in San Diego. If something happens to her, they probably wouldn't know for weeks. She does have a neighbor who checks on her plus myself. I can't get into her community because it's gated. All I can do is call or text. She has one other friend who is a caregiver and calls her so that's good. But my friend has told me she would never be able to afford assisted living. I suggested a caregiver who visits a couple times a week but she seems to think that's also too expensive. Here are some of the odd behaviors I've noticed and why it's a problem:

- We went to a Christmas party last weekend. The invitation said it lasts until 12:30. She was aware of that because she is the one who told me. Around 12:15, people started leaving. I got my stuff and was ready to go. She suddenly decided to use the bathroom. But returned several times to the table because she forgot something. By the time she got to the bathroom and was done, it was 12:45! Then she began a LONG goodbye. The people hosting this event were cleaning up and rolling away the tables! She was preventing them from doing their jobs because she wanted to talk to them more. I could see the looks on their faces. They wanted to go home really bad. I thought maybe I should interrupt and guide her out but she is not my parent. And she told me it upsets her when people try to rush her or treat her like a child.

- After she finally walked away, I told her the party ended at 12:30 and they needed to get going. She seemed agitated with me.

- We volunteer at a non-profit together. We always work together. Often, she will get a phone call from her doctors office. Usually the front office person, scheduler, or nurse practitioner. She will ask them questions for AN HOUR every time. Meanwhile, I am left to do all the work. I feel we should be using that time to help the organization. Personal calls can wait until we are done. The same thing happens, though, whenever I take her anywhere-- when I drive her or take her shopping. I feel sorry for the people on the other end of the line. What can be a 5 minute conversation becomes needlessly long. She always has it on speaker phone so I can hear everything. I've often wondered to myself: "Does insurance pay for this?? Is this phone call billable?"

- She risks being left behind on group trips. Example: She went on a trip to Israel right before lockdowns. I heard that the group leader's wife was trying to keep her moving so they would all make the bus. My friend got resentful about that and is to this day. I've had the same problem, though. Example: I took her to the San Clemente Pier. She had to stop and pet every single dog we passed on our walk. We missed our trolley, we were late to lunch, and we got home late because she is very easily distracted. Conversations with strangers are exactly like the doctor's office calls described above. It will never end unless the other person walks away first.

- As I said, she has to pet every dog she passes. She will approach security dogs that are working with security officers and pet them. She recently petted a random dog and got bit on the hand. She fainted from the bite and had no pulse! Someone called 911. She went to the hospital. Her friend tried to drive her car home for her but it wouldn't start because the battery was dead. Ugh. I don't know how well she is maintaining her car.

- Driving: She gets lost EVERY TIME she comes to my house. She has been to my house many times! When she finally finds the right street, she knocks on my neighbors' doors. Their houses don't even look like mine. She also drives her car backwards down the street in my residential area when she doesn't feel like making a turn. I did tell her not to do that. It's not safe. Someone even crashed into my son's car doing that. So now she makes illegal u-turns in inappropriate spots instead of just turning at the next logical place.

... I could give more examples but these are some of the reasons I wonder if she's having a mental decline or if she should even be responsible for herself without any real support. There are some other reasons that may be an explanation for...

- Loneliness. Older people do tend to talk a lot! Sometimes they are starved for companionship.

- Cultural / generational. I get it. I have family from the Midwest. If you've ever known a "Midwest goodbye"... you spend half an hour saying you should get going... they walk you out to your car where you spend another hour having a goodbye conversation. That's how it was in my family. That's not even her culture, though! But it also might be more a generational thing. So I don't know if that's what is going on with her or what. Combined with the other things, it's more of a concern.

Has anyone here ever had to intervene for an elder to have them evaluated? If so, who did you call? What were the signs that you noticed an elderly person needed assistance?
 
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Medicare Annual Wellness Visit and Health Risk Assessment​

Medicare pays for an Annual Wellness Visit once every 12 months. Prior to or during an annual wellness visit appointment, a Medicare beneficiary (or caregiver) can be asked by his or her doctor or health professional to complete a Health Risk Assessment (HRA). The HRA includes some questions about the beneficiary’s health which may provide important information to discuss with the health professional during the annual wellness visit, and can be used as a way of starting the diagnostic process. Care partners or caregivers can provide information to the physician prior to the Annual Wellness Visit to help ensure a thorough assessment.

Cognitive assessment and care plan services​

Medicare covers care planning services for people recently diagnosed with cognitive impairment, including Alzheimer’s and other dementias. Care planning allows individuals and their caregivers to learn about medical and non-medical treatments, clinical trials and services available in the community, and additional information and support that can contribute to a higher quality of life.

Special Needs Plans (SNP) for Alzheimer's disease​

There are Medicare Special Needs Plans (SNPs) available for individuals with dementia, including Alzheimer’s disease. SNPs are Medicare Advantage plans that specialize in care and coverage for beneficiaries with dementia. Only Medicare beneficiaries with dementia can enroll in these plans. Learn more information about Medicare SNPs.

To find the Medicare SNPs in your area: Use the online Medicare Plan Finder at medicare.gov or call Medicare at 800.633.4227.
 

What do I pay in a Medicare SNP?
If you have Medicare and Medicaid, most of the costs of joining a Medicare SNP will be covered for you. Contact your Medicaid office for more information and to see if you qualify for Medicaid benefits.

If you don't have both Medicare and Medicaid (or get other help from your state paying your Medicare premiums), your exact costs will vary depending on the plan you choose. In general, you'll pay the basic costs of having a Medicare Advantage plan.
 
Thanks, Momo! I will try to gently bring up these services to her. I wish I could accompany her to the doctor and tell them what I'm noticing or help fill out that risk assessment mentioned above. But whenever I have suggested driving her there, she refuses because she is very "independent". So she will only go alone. Hmm.
 
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