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You Can Bring A Horse To Water...

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You can bring a horse to water but you can’t make it drink

Here’s one for you.  She fell, and then she fell again. She has fallen so many times that it would be more efficient to list the times when she didn’t. But she doesn’t need help. She’s not, as she has said, “an idiot.”  Wait a minute. Now I am not a judgmental person, but I will play the role of devil’s advocate, yes, aunt of a client whose name shall remain safe with me, YOU are an idiot.

Why? Because you have at your disposal many nieces and nephews ready willing and able to help you find the care that you need, and you can afford it, but you are not one of those old people. Yet, you lay on your floor for 7 hours with a towel over your head until someone, I mean some people—plural, picked your 300 pound body off of the floor. You have cracked your head open twice from falling and you are bound to break your hip and die.  That’s what often happens to 76 year old women who break their hips.

I know that this sounds a bit ungerontologist like, but I adopt this demeanor to make a point, as ineloquent as it might sound….You can take a horse to water, but you cannot make it drink. She may be an idiot, but she is not delusional. Or is she?

Where is that line? It is the same question I have when I ponder the criminal defense not guilty by reason of insanity. Isn’t everyone who kills another person insane? Isn’t every person who chooses to live life on their terms when those terms mean self neglect insane? O.K., maybe it is a bad analogy, but we as a society and our legal system are going to have to seriously start thinking about this right to self determination.

Is it her right to break her hip and die on her floor? Is it the right of a person suffering from Alzheimer’s to be euthanized if that is a wish communicated when that person was as lucid as Albert Einstein, who as I might remind you, was the genius among geniuses who discovered, merely by thinking about it, that the universe was not as it seemed?

Is it the right of an older adult to slam the door on me when I come to see how they are doing upon being hired by an adult child? Is it my right to call those people idiots (even though it was in my non-judgmental role as devil’s advocate)?

I say, yes, yes and yes again. I believe in the right to self determination, period. HOW ABOUT YOU?

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Not Taking Your MEDS…Can Be Expensive!

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Raise your hand if you think that you should buy a worthless piece of property for $50,000 off an infomercial. Well if you are 85 years old, live alone and forget to take critical medication than the answer is, I guess.

That is precisely what a client’s father did this year. That was just a couple of days before he went into the hospital because of severe dehydration. Thereafter, he ended up in a nursing home to rehabilitate for three weeks.

When he got home and learned of his shopping spree, he was outraged and in complete denial. There was just no way that this fiscally responsible man would have done that.

Ahhh, those pesky IADLs (Instrumental Activities of Daily Living)—medication management, what a drag. This gentleman is on seven medications all of which have to be taken at different times throughout the day.

How could this have been avoided? Continue reading Not Taking Your MEDS…Can Be Expensive!

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When The Call Comes From The Elder….

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The other day something unusual happened. I received a call from an 88 year old woman who needed my advice about her daughter in law’s pushy (for lack of a better word) behavior.

Fearing that she would be institutionalized against her will, she wanted to know what her rights were. When I got to the woman’s house, she and her middle aged care-giver, greeted me with a warm smile and a welcoming gesture.

As she spoke of her daughter barging in, her eyes began to tear. The daughter, the wife of a son who passed away in his twenties, had begun a campaign to rid the home of the caretaker and the cat that the caretaker brought in and to place my client into some form of assisted living.

The daughter had even gone to a doctor’s visit where she made not so subtle illusions to the house being in a state of filth and disarray and run over by pets.

Concerned, the doctor had a social worker come to the home. The social worker reported that the house and living conditions were in perfect order.

Later that day, the grandson barged into the home and removed the cat that my client had come to love, insisting that my client had allergies and that she simply forgot about them.

My client was afraid that she would be snatched and institutionalized when she went to put her garbage out. Was this a paranoid delusion? Was the care giver up to no good?

Or, was this a case of elder abuse?

My findings were that my client’s mental capacity was very much in tact. Furthermore, she was very happy with her caretaker and wanted a pet. I spoke with my client’s doctor who agreed.

To this day, I do not know what her daughter in law’s motive was. Although she was in the will, placement of my client into an institutionalized setting would deplete her inheritance. My suggestion was two fold.

First, I could have the family participate in a family mediation to have everybody’s concerns aired and my client could assert her right to independence and autonomy, she could make her 80 year old sister a proxy under a durable power of attorney for health care or she could voluntarily submit to a conservatorship over herself. Short of that, she could get a restraining order.

That seemed a bit extreme. When I followed up with her she told me that she suggested to her daughter in law a cooling off time. They will meet in a couple of weeks to smooth things over with or without my mediation.

Empowered by two professionals assessment that she is not incompetent, I suspect that my client will now be in a position to assert her boundaries that she created over 88 years on this planet.

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