1) if you’re responsible for your person, you MUST have a signed Medical Orders for Scope of Treatment, aka Living Will or Advance Directive. It should be specific, including use of antibiotics, nutrition, palliative care. Talk about it even if it’s uncomfortable.
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2) watch the bank accounts. Keep the cards/checkbook with you. Get receipts for everything. Pay their bills for them, using online banking. If they need cash, you bring it to them. Be comfortable with having someone else be your auditor. If someone challenges, show documents.
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3) If you see something weird, don’t sit on it. If there’s money missing you can’t explain, start poking. If there’s an arrangement that doesn’t make sense, stand up for your person. If the explanation for the arrangement doesn’t ring? Contact Adult Social Services.
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4) Get your person as used to technology as their maximum capability allows, as early as you can. If your person is in a place where they can learn to use Instacart and/or Postmates, this is to their advantage. But even the ability to use Netflix is better than cable.
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4a) commercials are *bad* for dementia — they break concentration, they’re loud and jarring, they often sell complete bullshit. Your person is better off binge-watching 10 seasons of Bones than all of Food Network or Crime TV.
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5) there comes a point where you’re more concerned about your person eating anything, rather than *what* they’re eating. If a daily chocolate shake and a burger makes them happy and gets food into them? Go with it. Quality of life matters when there’s not much left.
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6) Remember your person can be an unreliable narrator. They’re not lying. Memory slips are a thing, and logic can get strange. They’re scared and feeling out of control, because they are. Getting old is not for amateurs. They will make as much sense of their world as they can.
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7) OTOH, if your person seems out of character, pay attention. Disorientation is a sign of infection and/or dehydration, often before you can find a fever or see any other signs. Urinary tract infections & pneumonia hit fast and hard and they’re common.
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8) Outsource. Your teenager wants driving practice? Send them to their grandparent/auntie; tell them to pick up the favorite food. Someone says “let me know if there’s anything I can do”? Tell them you need a casserole or a lawn mowed.
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9) Get ok with the idea that your person has limited time. Don’t try to control everything. Make sure they have as much agency and autonomy as possible. Let them make every decision they can, even when you disagree, as long as it does no harm. Be flexible. Love the time you have.
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10) the goal with skilled nursing/hospital is that your person doesn’t *lose* ability/cognition, but expect that they may lose ground while in care. Their routine & environment is disrupted. If OT/PT is available — YES, you want it. Every time.
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11) last one: take care of you. Share the responsibilities. Schedule your own downtime. Put the oxygen mask on your own face before assisting someone else. Being responsible for another person is hard work; so is being cared for. It’s emotionally intensive labor for both of you.
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Tomorrow I will do the opposite thread: how not to do the caregiving. (It mostly boils down to boundaries and saying NO and being proactive now before your objectively terrible person ends up in the ER, but there’s no reason you MUST be a caregiver for someone who hurt you.)
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