TRANSCRIPT

Tips for Living Independently and Safely with Alzheimer's & Dementia

(Podcast #029)

 

0:00  
Just because you have a new diagnosis of dementia does not mean that you cannot live independently, and does not mean that it's just a lost cause, a done deal. These tips are designed to help you live independently and safely for as long as possible. And also tips to help slow down the disease course. There is a lot you can do to live your best life, even with a dementia disorder. I will say there is also a lot that it takes emotionally and physically and socially, in terms of with your friends and family to come to terms with a dementia diagnosis. The more you're able to gather what you need to stay living independently as long as possible, the more likely you are to stay living independently for as long as possible. And I want that for you. I imagine your family wants that for you and your doctors want that for you. And we want you to be safe. We want you to be happy, and we want you to be independent for as long as possible.

1:06  
I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain with dementia, relationships and sex, caregiving, and even end of life. Like I say in my therapy group, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place. Let's get started.

 

We help mental health and senior care professionals meet the mental health and sexual health of older adults

1:47  
Did you know that by 2034, there will be more adults 65 and older than children under the age of 18. Let me break that down. In 14 years, there will be more older adults than children in the United States. It is imperative that mental health, medical and senior care providers know how to effectively address the mental health and sexual health needs of older adults. For more than 15 years, I've been providing mental health care to older adults and their families. And I'm happy to share that I am now offering consultation and training to mental health and senior care communities. As you know, best practices call for a multidisciplinary approach to care. And so I have partnered with my best friend and colleague, Dr. Lisa Frank, who is a Board Certified psychiatrist, and who specializes in older adults. Together, Dr. Frank and I consult with medical and mental health and senior care communities in three ways. We offer clinical consultation. So if you're struggling with cases, both mental health and sexual health cases for older adults, we provide information and feedback using evidence space and best practice models. We also consult on program development. So if you're wanting to build a senior behavioral health clinic for your agency, we can help with that. And then one of my favorite things is training for staff. Some of the most popular trainings that I offer include training providers on core competencies and working with older adults and mental health care and training senior care providers on sexuality and dementia. You can learn more about working with us by visiting my website -  www.drreginakoepp.com/professionals. I'll put a link in the show notes because that's a lot to remember. So, head on over to the show notes and check it out and learn more about some of the services that we offer.

 

Today, on the podcast, I will be sharing tips for living alone successfully with early stage dementia. And the tips that I'm going to be sharing are actually tips provided by the National Institute on Aging. One of my priorities here on the podcast is to make sure that all of the information that I share related to Dementia Care, related to mental health care, related to sexual health care has evidence base to support it. So today, five tips for living alone for as long as possible with early stage dementia. What I'm going to do is list all the five categories and then I'm going to break them down and talk about each of them.

4:40  
Number one is to simplify your daily tasks. Number two is to make sure that your home is safe. Number three is to plan for your future. Number four is to gather your support system around you. And number five is to manage your medical and mental health.

Let me start by saying a few weeks ago, I had an episode on the benefits of early diagnosis of dementia. And this is where it's really important, the earlier a person is diagnosed with dementia in the dementia process - and dementia is an illness, it's a disease, the most common type of dementia is Alzheimer's disease. The earlier a person is diagnosed in the dementia process or in the disease process, especially for Alzheimer's disease, the more likely they are to put these five tips in place, and the more likely they are to live in their home for as long as possible. Just because a person has dementia doesn't mean that all of a sudden, they lose independent living, they lose their ability to drive, lose their ability to manage their money, lose their ability to vote. And we'll be having an episode on voting and dementia, hopefully, fingers crossed. And so I want to just point that out that just because a person has a diagnosis of dementia, or mild cognitive impairment, doesn't mean that they cannot live independently. And so the five tips that I'm going to be talking about today will help you if you have a new diagnosis of dementia, and you're in your early stages, we'll help you to live independently for as long as possible. If you're caring for a loved one, and you're a long distance caregiver, and maybe you have an older loved one who lives in another state and they're living independently, these tips will also help you to help your older loved one live independently for as long as possible.

 

Download the free memory loss guide

To help you understand dementia and memory loss, I've created a memory loss guide. In the memory loss guide - it's free, so I'll link to it in my show notes in please download it, it will really help you - it explains what memory loss is like what some of the warning signs are. It talks about the benefits of early diagnosis and kind of walks you through what you need to do if you're concerned that an older loved one might have memory loss. So download that guide. I'll link to it in the show notes. And like I said it's free. So check it out. Now let's get into the five tips for helping folks with early stage dementia live alone and live independently for as long as possible.

 

Strategy #1: Simplify Daily Tasks

7:20  
The first tip is to simplify daily tasks. And this is really to make everyday tasks easy. So you don't have to use a lot of your brainpower to think of the simple things in your house to do. The first thing to do is to be very clear about what your days look like. So to have a very clear schedule. And it's recommended actually, for folks with dementia, that there is a consistent routine, so that it can really help to organize your days. So make a list of what you'll be doing for the whole week. So if you have doctor's appointments, if you're receiving Meals on Wheels, if somebody's coming to visit, if you have a church group, if you have a senior zoom call, write down your appointments and your to do lists each day and try to keep a consistent schedule. So kind of eat at the same time every day breakfast, then have whatever your activities are, then eat lunch at similar times every day. The more you can keep your days consistent, the better for your brain. And also, the more you can use like a calendar, or a to do list, that's also going to be very helpful. What I see in my practice, when people have mild cognitive impairment or early stages of dementia is sometimes folks forget their medical or mental health appointments. And when they start forgetting them too often, we think, oh, something's going on. And the person's not able to manage their appointments, and it gets a little concerning for providers. So the more you can organize your days, the better. It'll keep you independent for longer. The other area that's really important to manage well is in paying your bills. So if you need to pay rent, or mortgage or your water bill or your trash bill, you get the idea. Setting up automatic payments, is a great way of not having to think about it too much. It can get complicated if you're not that familiar with computers. And so maybe having a family member or friend help you who you trust, of course, help you set that up could be very helpful. If there is a family member who you trust or friend who you trust, even doing like a checks and balances with your family member or friend around having them help to review your financial statements to see if there are any issues could be very helpful.

9:55  
Sometimes, with a dementia disorder, you might not have clear awareness when there are issues. And that's just the nature of the illness, it doesn't mean that's your fault. And so it could really help to have a person that you trust, kind of reviewing your finances with you, maybe on a monthly or quarterly basis so that they can identify any red flags and see if anything suspicious that you paid too much for something or too little for something. So that could be very helpful. The other big one, when it comes to simplifying your daily tasks is that a lot of older adults are taking many medications. I mean, I don't know about you, but even taking one medication, Sometimes I'll think, "did I already take this medication today? Did I already take my probiotic?" I mean, it's just one medication. And so if, if you have mild cognitive impairment or dementia disorder, you'll want to really set up your medications so that they're easy to remember to take. And so that you know that they're dosed accurately. So one way to do that is like using a pill box or a pill box with reminders, there are like medication dispensers. So check in with your medical provider who's prescribing this, like I said, it can get cumbersome, because if you're prescribed a lot of medications, that means you might also have a lot of medical providers. And, and so just something to be mindful of it might be a lot to manage. And so like paying bills, you might want to have a trusted family member or a friend helping you to navigate and coordinate all of that.

11:38  
Another way to stay living independently as long as possible, and with simplifying your task, is to make sure that you have adequate nutrition and meals. So there are lots of meal delivery programs like Meals on Wheels, which I'll include a link for in the show notes. And they deliver free or low cost meals to your home. There are also meal programs that are for profit, and you can pay to have somebody prepare and deliver meals. The important thing here is to make sure that you are getting adequate meals and nutrition. One of the things that does get concerning when you're living alone is like dehydration and not having enough nutrients or nutritional intake. So being very mindful of your meals. And this is where your schedule that we already talked about can be so helpful. Because if you are maintaining a consistent routine every day, and you know that you eat breakfast at a certain time and lunch and dinner at a certain time, then you might be more likely to think about what will you be eating during those times, and then prepare for that.

12:51  
Okay, and finally, there's transportation. And so if you're newly diagnosed with dementia, and you're in the early stage, you might still be able to drive and that is wonderful, and you might still be able to drive safely. There might come a time, however, that you might be getting confused or more likely to get fender benders or people are honking at you more. And so if that is happening, you'll definitely want to prepare for how to get around independently after you stop driving. And the sooner you could start to think about that, the better. I also have a road map to safe driving guide that I will link to in my show notes and it helps you to think about getting around independently even after you stopped driving. So I'll link to that in my show notes as well. For more food and transportation options, there are community agencies that are actually like state and government run called Area Agencies on Aging. And they are familiar with all of the local resources near you nonprofit and for profit resources just for older adults. They can be so helpful with learning about Meals on Wheels programs and alternative transportation programs. And so even like medicare/medicaid counselors, and so to find your local area agency on aging, I'm gonna put a link to the eldercare locator and you just simply put your zip code in and they will link you to your agents, the agencies in your area, and then please call them. They're trusted reputable agencies. They can help you think through what resources are available in your community.

 

Strategy #2: Make sure your home is safe


14:41  
So, the second tip is to scan your home for safety. According to the National Institute on Aging, they suggest de-cluttering your house and getting rid of things that you no longer need or use like extra furniture, extra clothes. They suggest removing objects on the floor like heavy rugs, that could increase your risk for falling or like electrical cords that you don't want to trip over. You might want to install handrails and things like that. If you're noticing that you're becoming more and more forgetful, there are resources to shut off your stove automatically. You'll also want to consider carrying a life alert button or a life alert watch. So if something happens, and you need to call for emergency services, a life alert necklace could be helpful. And then making sure that your smoke and carbon monoxide detectors are working and working well.

 

So I want to just say, if you're listening to this and you're newly diagnosed with dementia, it would be normal to experience fear and loss and sadness right now. And my heart goes out to you. It's a big adjustment to make. And it's scary. And the goal here is not to scare you, but to help you live your fullest life even living with dementia disorder. With that said over time, for folks with dementia, especially Alzheimers Disease, six out of 10 people will wander away or forget where they live or become confused when they're out in less than familiar areas. And so it can be really helpful to have something like a medical ID bracelet if you get lost. And there is a great really affordable program by medic alert and the Alzheimer's Association they joined together and created a safe return program. I'm going to put a link in the show notes to the Safe Return Program. It is so, so helpful. And they give you what a response plan would look like if you do get confused and are away from home and need to get back home. This safe return program would also be really important to share with a trusted family member or friend so that they know what to do. So they all know what emergency protocol to follow as well.

17:17  
Let me just stop here and review the tips that we've covered so far. The first tip was to simplify your daily tasks and organize your life and keep a routine. The second was to make sure that your home is safe, and to put safety mechanisms in place. And now we're moving on to the third tip, which is to plan for your future.

 

Strategy #3: Plan for your future

17:43  
One of the most important things that you can do when you're newly diagnosed with dementia, especially when you're in the early stages and still have capacity to make all of your decisions and express your wishes clearly is to do just that - is to prepare all of your legal and financial matters as soon as possible. So you'll want to gather all of your essential documents, you'll want to get all of your legal affairs in order all your financial affairs in order, you'll want to prepare your advanced directives or your last will and testament. So you'll want to assign a healthcare power of attorney and a financial power of attorney.

18:26  
All of those things. I feel like I have resources for everything. But so for this, I have created an essential documents guide. And so I'll link to that in the show notes as well. And you can go ahead and download the essential documents guide as well. You'll also want to be thinking about, as your care needs change over time, what your options for in home care might look like. Like if you need a home health assistant to come in and help you and what Medicare plan you're on and what they cover. If you're a veteran, what resources are available to you through the Veterans Health Administration, you'll want to learn about long term care and paying for care. And so one of the ways that you can do that is with that eldercare locator and the your local area agency on aging. They often have medicare/medicaid counselors to help you think through that. And then they also know what's available in your community. So that's a really good place to start. And then have a plan for what happens when you are no longer safe to live alone. So the earlier you can think about other options for living, the better.

 

Strategy #4: Gather Your Support System Around You

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Number four is to gather your support system around you. One of the best ways to stay living independently for as long as possible, is to be sure that you do have a community around you so that you don't become isolated or withdrawn. That will actually accelerate the disease process, unfortunately. So the more you can have people that you love and trust around you, and spending time with you, the better. So identify the people that you trust and write down their names and phone numbers and where they live. Keep that. Maybe you make a copy, a few copies, of it and keep it in important places like on your refrigerator, in your car, maybe you share it with your durable power of health attorney and durable power of financial attorney. And just to be sure that your friends and family have access to one another as well. You can also, in terms of gathering your support around you, have a trusted doctor or neurologist who you work with regularly who can keep track of your own advancement with dementia. And ask those care providers to sort of write down a care plan for you.

20:53  
You might also consider sharing your diagnosis with neighbors that you trust. Neighbors are often the first people to notice if you are not yourself or having a bad day or if you look lost. Also, you could give them that sheet of your contacts or the people that are closest to you that we just talked about. If you are newly diagnosed with dementia, there are great resources available with the Alzheimer's Association. So the Alzheimer's Association provides support and resources to adults with dementia and to their families. But you don't have to only have Alzheimer's Disease. They provide support for all dementia disorders. Alzheimers disease, like I said earlier, is the most common type of dementia. But it's not the only type of dementia. And if you have like a Lewy Body dementia or a vascular dementia, you can still contact the Alzheimer's Association for support and resources. They also offer support groups for people with mild cognitive impairment and early stage dementia. So please check them out. I'll link to them in the show notes as well. Some communities have what's called a Memory Cafe where you get together and talk with other folks with early stage dementia and just spend time together. I think it's happening more over zoom right now, definitely, definitely check it out.

 

Another piece of gathering support around you is if you are noticing that you are becoming depressed and I will say with a new diagnosis of dementia, there is evidence to show that there is an increase of depression, it increases the risk for suicidal thoughts and actions. Please know that we can help with that, that you don't have to live with this level of suffering. If you are having suicidal thoughts, or extremely depressed or feeling crisis, please call the National Suicide Prevention Lifeline. And I will give that information in the show notes as well to give you their phone number right now, it's 1-800-273-8255 definitely call there's no shame in calling it they're there to help you. It's a tough road in the beginning of living with dementia and adjusting to a new diagnosis. So please take care of yourself and gather that mental health support around you if you need it as well.

 

Strategy #5: Maintain Medical and Mental Health

23:23  
Number five is to maintain medical and mental health. And so what we know, and last week I had an episode on the best ways to prevent dementia, even if you do have dementia, these are some of the best strategies to help slow down the progress of dementia. So one is to exercise so you could just simply go on a walk or garden or go outside. This is especially important during COVID where people are feeling more and more isolated. Another way to slow down the progress of dementia is a healthy diet and healthy sleep habits. So getting seven to eight hours of sleep a night. Managing your stress, and managing stress can be... one really helpful strategy is walking and gardening just like we said. So it's kind of all of these work together. If you're exercising, you're more likely to sleep well. If you're eating well, you're more likely to exercise and sleep well. Or exercise and healthy diet and good sleep are great ways to manage stress. And then staying social is actually one of the best things that you can do for your brain. So studies show that even folks with dementia who remained social actually have better outcomes and live independently longer and have a slower disease process.

24:50  
Two final things. One is if you have struggled throughout your life or you're noticing now that you're experiencing mental health concerns like insomnia, depression, anxiety, suicidal thoughts, please get connected to mental health providers. I'll have in my show notes how to do that, a list of where to find mental health providers who specialize in older adults. And also the more you can manage your medical needs, like if you have any heart disease or vascular issues, and you're taking medicine. So the better you can care for your body with sort of following medical advice around what sort of medications you need for your body to function. Well, that will also help your brain.

25:33  
I threw so much information at you, I hope that this is helpful. And really I want to share that just because you have a new diagnosis of dementia does not mean that you cannot live independently, and does not mean that it's a lost cause, a done deal. You can live independently for longer than you might think, and safely. And these tips are designed to help you live independently and safely for as long as possible. And also tips to help slow down the disease course. There is a lot you can do to live your best life even with a dementia disorder. I will say there is also a lot that it takes emotionally and physically and socially in terms of with your friends and family to come to terms with a dementia diagnosis. And so please take care of yourself. This is a long road. The more you're able to gather what you need to stay living independently as long as possible, the more likely you are to stay living independently for as long as possible. And I want that for you. I imagine your family wants that for you and your doctors want that for you and we want you to be safe. We want you to be happy, and we want you to be independent for as long as possible.

 

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26:55  
I am going to say goodbye. I will be linking to tons of resources in my show notes, so please go check them out. If you're a professional, a mental health or senior care professional, interested in consulting or receiving training, check out my website for more information.

27:13  
If you like this episode, be sure to subscribe so you'll be the first to know when new episodes are released and then leave a review. Subscriptions and reviews help people to find this show. In wrapping up, it's important to share that the ideas expressed in this episode are mine alone. And that information shared does not take the place of licensed medical or mental health care. We'll see you next week. Same time, same place. Lots of love to you and your family. Bye for now.

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