Sometimes Kids Just Have to Take the Bull by the Horns

There is a Point Where the Person With Memory Loss Can No Longer Make Decisions for Him or Herself

In the past week, I have made two home visits to prospective clients of Seniors’ Choice at Home, a non-medical home care service with the goals of:  1) helping seniors stay where they are longer with some practical help; and 2) providing some backup for adult children or other helpers as they try to balance the busyness of their own lives with the help their elderly parents/neighbors/friends need.  In both cases, the elder refused the help because they viewed themselves as OK.  In both cases, the nurse will probably need to involve Adult Protection because of the vulnerable state of the elders and because there is a mandatory reporting law in our state.

It is so common for us as adult children to find ourselves in denial about the reality of a parent’s condition.  No matter how mature and responsible we are, there is still that mystique around our parents being our parents.   It’s even more difficult for adult children who live across the country from  parents.  Sometimes when returning for a visit after a few months, the changes are obvious, but then it’s tempting to chalk it up to “a bad day.”   We want so badly to allow our parents their independence, to respect their right to make decisions about how they live their lives.

David Solie, M.S., P.A., in his book How to Say it to Seniors talks about what he believes is most important to older adults–the ability to be in control of one’s own life.  I agree with him up to a point.  When the decision or change the elder needs to make isn’t a matter of life or death, or when the person is of “sound mind,” it’s wonderful to be able to allow the elder to make the decision.  “Mom, I know this is difficult for you, but you are in charge of your life, you are in control, you can decide what you want to do.”   However, if your mom is lying on the ground struggling for breath, you don’t ask her if she wants you to call an ambulance.

With Alzheimer’s disease and other dementias, parts of the brain are destroyed and no longer function in the way the did in the past.  At autopsy, a diseased brain has lost as much as one third of its normal weight.  There are actually large spaces in the brain where cells have died.  The brain has had a “heart attack” and the person is gasping to think.

When an elder has significant cognitive impairment, when the doctor, the visiting nurse, and/or the neighbors  have serious concerns  about a parent’s safety, it’s time for the adult children to step in and make the recommended changes.   It’s probably one of the most difficult things for an adult child to do.

Minnesota Occupational Therapist Clarifies Allen Cognitive Levels

The Allen Cognitive Levels:  What Are they and What Do They Tell Care Givers?

Allison Bakke, of Above & Beyond Seniors Services has submitted a wonderful clarification of the Allen Cognitive Levels.  If you are dealing with a person with Alzheimer’s Disease, you are likely to come across the term.  The Allen Cognitive Levels are cognitive scores on a 1.0 to 6.0 scale that are obtained through tests completed by an occupational therapist.  These scores allow the occupational therapist and others to determine a client’s abilities, as well as, define areas where help may be necessary.  When using the Allen model professionals are always striving to help the client attain his or her “best ability to function” in relation to the cognitive impairment.  The Allen Cognitive Levle scale is used by both healthcare professionals and family caregivers to understand both abilities and deficits related to dementia or cognitive impairment.

Scores at a 1.0 Level are considered a “severe” cognitive impairment, while a score of 6.0 would be considered “normal” or unimpaired thinking.  Therapists use the scores to guide caregivers in a client’s ability related to activities of daily living (ADLs.)  These include dressing, grooming, toileting, bathing, cooking, driving, and money and medication management.  For example, a client functioning at an Allen Level 2.0 may be able to help move or place his/her arms in position to put on a shirt, this person is more than likely a resident in a lon-term care facility or memory care residence.  In contrast, a person with an Allen Level score at 5.0 would like live independently in the community with weekly support for medication management and assistance with complex problem solving.

Occupational therapists set up programs to maximize independence based on the client’s congitive levels, problem solving ability, safety and judgment, in addition to, considering the individual’s physical abilities.  Occupational therapista and caregivers are great partners for collaboration to attain the independence our clients desire and deserve.

Many thanks to Allison for this summary of the Allen Cognitive Levels.  Above and Beyond Seniors Services, located in Rogers, Mn, is owned and operated by Allison, an Occupational Therapist and her partner, a Physical Therapist.  You can learn more about what they offer to Twin City area residents at their website:  www.aboveservices.com.