Help for Alzheimer’s Caregivers

Whats available when a loved one has Alzheimer’s

 What you are up against

Alzheimer’s disease is a type of dementia that is most frequently seen among the older population. Since the mission of Better Insurance Options is to assist the senior population, I felt this was an important topic to cover. The dive I took into this topic was both educational, and stunning.

My personal introduction to this disease was through my Grandmother. She had a particular trait that I am told is actually not uncommon among Alzheimer’s patients. She was quite cognizant that something was very wrong, but she would not accept that the issue was her Alzheimer’s condition. Rather, she decided that her loss of memories and abilities was due to her being poisoned by us, her family, via the very medications that were intended to help her. That was the point where I came to grips with the simple fact that dealing with Alzheimer’s can be very stressful for the individual who has this condition, as well as for the loved ones and care-givers who attend to that individual. At the risk of stating the obvious, it can be psychologically devastating for all involved. I found out since that time, through the research I have done, that this disease is in fact a double-edged sword; it is most frequently financially exhausting as well.

What is this condition, exactly?

Clinically, the Alzheimer’s experience is characterized by a worsening of the person’s cognition, particularly in thought, memory and in language. The onset of Alzheimer’s disease usually begins a progressive decline in the effected individuals ability to perform activities of daily living, and in later stages, it may even be accompanied by changes in behavior. Ultimately, this disease may render the effected individual in need of total care, because in later stages, it affects even the most basic skills necessary for his daily existence.

Solutions will suggest themselves

Fortunately, most of the issues require only simple solutions, and just a little bit of loving care. Let me illustrate with an example concerning mealtime.

For a person with Alzheimer’s, just regular eating may pose a challenge. There are normal physiological changes that come with aging, such as a diminished sense of taste and smell, and indeed, this natural progression may affect the individual’s desire to eat. But when dealing with Alzheimer’s, the person may even forget to eat entirely. In other cases, the effected individual may want to eat but has forgotten how to prepare meals. Through the course of the disease, the victim may eventually lose their table manners and/or may have difficulty in swallowing. Agitation and distractibility may also develop, in fact they are a frequent, and almost an expected side effect of the gradual loss of cognition. To alleviate these problems, caregivers often find it necessary to patiently and lovingly remind their loved ones to eat or even instruct them step by step on how to prepare meals.

Small, frequent meals make more sense than larger, more elaborate meals with extensive prep time, and finger foods that are high in calories are a great idea. Decreasing the environmental stimuli, by taking extra utensils off the table and using bright, solid-colored plates may address the easy distractibility. And to encourage self-reliance, the person may be provided with spoons that have large handles rather than forks, and bowls rather than plates.

Nutrition is just one of the many hurdles caregivers face when dealing with Alzheimer’s. But the point is, with some loving thought, combined with physical and emotional preparation, solutions will come to mind. People with Alzheimer’s disease will often need assistance with other activities of daily living such as bathing, toileting and changing, but in each case, solutions will present themselves to caregivers who are both patient and loving. To complicate the situation further, it is necessary in all cases to balance the patients need for assistance with as much independence as possible. The caregiver must allow the affected individual to do as much as they are able to do while providing the least amount of help. For this, patience and flexibility are crucial.

So while again placing myself at risk of stating the obvious, I will say that the details of this gradual loss of self-reliance are very individualized, and for that reason, it will not be useful to detail what may need to be done. You will have to make it up as you go along, just like raising a child, and you will. However, on a psychological level, there will be experiences that you cannot possibly prepare yourself for. Experiences like when your loved one, who is absorbing as much care as you are humanly able to provide on a daily basis just cannot recall your name, calls you by a different name, or even reacts out of fear because, to them, you are suddenly a total stranger. 

You will find the strength

But believe it or not, there is a gold mine of psychological and emotional fulfillment for the caregiver  in this situation who is willing to embrace it. To understand how it can be fulfilling, I want to associate this with another personal experience of mine. This one is totally unrelated to Alzheimer’s, but it does speak to emotional fulfillment.

Everyone who is a dog lover seems to have a legendary dog in their history, and I am no exception. I had a great big, 120 lb Labrador Retriever named Augie Dogie. However, over the years that I owned this dog, who was, oh, so awesome, I developed complications from a torn ACL, and subsequent surgery. It became a chore to walk him each night, and I came to resent it to some extent. But after we put him down, ironically due to his own joint problems, hip displacia, I wanted nothing more than to walk my dog again, and to this day, about 20 years later, I still miss it.

My point is not to elicit sympathy from the reader. Quite the contrary, if you are reading this, it seems likely that you know someone with Alzheimer’s, and you quite correctly have my deepest sympathies. But here’s my point with the stupid dog story, and please don’t miss it.

It is frequently from within the fires of the most testing of emotional circumstances that the strongest bonds of humanity are built. This is the time and place where we find the greatest strength from within ourselves. That applied to me and my dog, and it most certainly applies in a manifestly more substantial way to any individual who is dealing with Alzheimer’s in a loved one. It is in these circumstances that people often realize how strong they can really be for their loved ones. While watching a loved one fade in this way is heartbreaking, and I think it is safe to say that dealing with Alzheimer’s is one of the most difficult jobs in the world, it is important to take from the experience what is available to you. A sense of awe at your own courage is one of those gifts. When in stressful situations such as this, it is more important then ever to take good care of yourself, and to allow yourself to develop an appreciation for your own courage, strength, and yes, I will say it, even nobility.

I want to be careful to not paint too gloomy of a picture here. Yes, its bad sometimes, but a lot of the time is just normal. You will have an opportunity to recover from difficult episodes, but it is wearing on ones psychological well being to know that there is more to come. 

Will Medicare help with Alzheimer’s?

OK now to more positive topics. There is help available, although you may have to dig. It is there. The first question I researched was related to my professional concern, how Medicare may be able to help. I had to do some research to find answers to this. Both Medicare Parts A and B provide options for home health care, but it must be recommended by a physician, and that’s where it might become complicated. It shouldn’t be, but unfortunately, it might. The reason is that the availability of help is directly related to the degree of severity of the condition in the affected individual, and since cognition and self-reliance usually will come and go among Alzheimer’s patients, it can be difficult to measure. As the caregiver, you will know, but the attending physician may not see the same picture you do. The good news is that far more physicians are willing to be sympathetic to this condition then ever before.

It is possible to find, in select areas, a Medicare Advantage insurer that has elected to create an EDM plan for Alzheimer’s patients. EDM stands for Enhanced Disease Management, and evidently these programs are both rare and experiencing little success. You can read an article about this here.

Medicare Managed Care for Alzheimers

The article is specific about only two organizations providing help for patients with Alzheimer’s, and with the average costs detailed in the article, it might just be worthwhile to relocate to one of those states. I know that may sound crazy, but you should read the article. Certianly if you are in this kind of situation, it is worthy of further research. These plans do exist, and if you are in one of those areas, I am sure it will help. To find these plans, or other programs that may be available in your own area, you should try visiting alzheimers.net. You can find a comprehensive listing of programs by state, and a number to call for trained advice on how to find help.

A Medicare supplement will reduce your financial burden, but of course, you will have to obtain one during a guaranteed issue period, or underwriting will most likely deny the application. For more information on Medicare Supplement eligibility I have produced a video, and you can find it here. Long term care insurance is extremely helpful in this situation, but it is frequently impractical to buy later in life, because the premium goes up dramatically, and once again, the condition of Alzheimer’s will result in a denial of the application.

Is there other help available?

And this is where I turn you over to the experts who know far more than I do about the topic. I recommend both the Alzhiemer’s Association (alz.org) and the National Institute on Aging (nia.nih.gov). You can find more support through Google, and this is undoubtedly the most fertile of all fields of help available.

After having highlighted just a few of the difficulties of dealing with this disease, I would like to make you aware that it may be possible to be paid to be a caregiver. With the task before you, caring for a loved one that has Alzheimer’s, it is worth looking into.

Caregiver pay

Full disclosure, through my company, Better Insurance Options, I have no direct assistance to offer to Alzheimer’s victims, although I would if I could find a plan to represent. There are two possibilities that insurance could help with, and I mentioned them above. To review, the first is to obtain a Medicare supplement plan when the patient is in a guaranteed issue period, and the second is to obtain a long-term care plan early in life, when it is more affordable.

In summary, Alzheimer’s is a condition that requires a whole lot more attention than it gets. If you are in the position of helping one of these victims, I can offer sympathy and prayer, but not a lot of real, useful help. I can only hope that things get better soon.

Frank Sutter has been a licensed professional insurance agent since 2010, focusing almost exclusively on the Senior Market. He lives in Eastern PA, and is licensed to do business in Pennsylvania and Arkansas at present.

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