Speaking on behalf of someone and making their medical decisions is a big responsibility. As an ER physician, I see most dementia caregivers waiting too long to consider and define goals of care for their person. Often this topic was never discussed before the person lost their ability to speak for themself. Caregivers tell me […]
A Confident Dementia POA Easily Communicates Goals of Care. Read More »
Determining goals of care is a foundational step in making a medical care plan for your person. It is work that can not be avoided if you want to have a plan because every decision will be based on the person’s overall goals. If you haven’t already, I recommend you read my first goals of
4 Steps for a Successful Dementia Goals of Care Talk Read More »
Before we get started with the 5 Steps, I want to share a strong value I hold as a physician, but also as a human being. I believe when someone is sick, they should be given the information they need in order to understand the treatment options available to them. With this information they can
Even working exclusively night shifts, I care for a patient living with dementia almost every shift I work in the ER. There are so many challenges the person faces themselves, but also the people who are advocating on their behalf. To do right by those affected all over the world our collective approach to dementia
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A change in the way the person is acting or behaving is one of the most common reasons a person living with dementia will be seen in the ER. This often looks like increased confusion, agitation, or the person speaking less and being more withdrawn than usual. We call this a change in mental status,
How to Troubleshoot Sudden Behavior Changes in Dementia in 6 Steps Read More »
Before we discuss the 3 ways to become a medical decision maker, I want you to be aware that in the US there is a federal law which allows us to “direct our health care wishes in advance.” One way to do this is by naming the person you want to make medical decisions on
3 Common Ways to Become Someone’s Medical Decision Maker Read More »
Let’s kick this off by getting clear on what “Critical Care” actually means. To make it simple, I want you to think of this as care that will ultimately happen inside a hospital. It supports someone through an illness or condition which threatens their life or their body’s ability to function. Critical Care can and
Critical Care & Dementia: What Decision Makers Need to Understand Read More »
Before we get started, I want to make sure you are in the right place. This article is meant for you if you are making medical decisions on behalf of a person living with dementia and they did name a medical decision maker in a legal document such as a “Medical Power of Attorney” form.
Have a POA? How to get Dementia Families on the Same Page Making Medical Decisions. Read More »
Before we get started, I want to make sure you are in the right place. This article is meant for you if you are making medical decisions on behalf of a person living with dementia and they did not name a medical decision maker in a legal document such as a “Medical Power of Attorney”
No POA? How to get Dementia Families on the Same Page Making Medical Decisions Read More »
As an ER physician, I often have to care for patients who can not speak for themselves. I believe that every adult in the US (anyone over 18) should name a person, as well as a backup, as their stand-in medical decision maker in the case they are unable to choose for themselves. Naming someone
Dementia and medical power of attorney (POA) forms. What you need to know. Read More »
In my experience, almost every ER visit will fall under one of two categories. We’ll discuss both in this post. While you read, keep in mind, your person will be highly likely to face one, or both, of these overarching issues at some point in their life. First, let’s discuss falls. This is one of
Why People Living with Dementia Come to the ER Read More »
I will discuss 3 of the most common classes of medications used in response to dementia related behaviors. Be aware there are additional classes of medications I am not going to cover. Before we get started, there are some things I want to make clear. 1 – This is not medical advice for you or
Medications for dementia related “behaviors” – What you need to know. Read More »
I often hear caregivers saying their persons’ dementia worsened after anesthesia. It is a common topic discussed inside support groups. Just like in text messages, online posts can leave a lot out. I have found myself wondering if the caregiver holds the belief that it was the anesthesia alone that made their person’s dementia worse.
ER physician’s opinion: How to think about anesthesia and dementia. Read More »
The answer is no. Absolutely not. Let’s talk about the concept of “hospital transfers.” I want to give you some things to think about and consider for your person. First, what does hospital transfer mean? When I use this term I am referring to your person physically leaving where they live and being brought to
Person Living with Dementia Values Quality of Life? Do they always need the hospital? Read More »
If you are wondering when is the right time, you are in good company. I want you to know there is no “right” time or reason to move your person. It is going to depend on the person and your unique situation. Some common reasons for a move are concern for the person’s safety, need
Is it Time to Move Your Person Living with Dementia? Read More »
If you missed last week’s post with tips 1-5 click here to get caught up. Tip #6 – Tell us your person has dementia. I know this may seem unnecessary. You might be thinking, but it’s in the record. You might be right. It could be listed there. It should be listed there. If your
Going to the ER with Someone Living with Dementia? – 10 Tips for less stress, part 2 Read More »
Tip #1 – Have a goal or reason for coming to the ER When you come to the ER please tell us the reason you are there. It is that simple. We need to understand the goal you have in mind for coming to see us. This applies to you yourself and when you bring
If this is your situation, please know you are not alone. You are amongst many other caregivers. By the time people are diagnosed with the disease that is causing their dementia they often are unable to declare their wishes. Even when the disease is recognized and diagnosed, people can be hesitant to seek out the
Person with dementia has no written wishes? Read More »
It is no secret that caregivers are suffering from burnout. I want you to know, there is nothing wrong with you. Healthcare professionals like me are also facing burnout at alarming rates. Personally, I don’t like the term burnout. It implies that there is something wrong with us, that we are the problem. It used
A “Burnout” Solution for Dementia Family Caregivers Read More »
I want to make you aware of common medication related issues I see often in the ER. Hopefully you can avoid these scenarios in your person. If you have your person’s medication list handy, take a look at it while you read this. Write down any questions you might want to ask their care team.
People with Dementia in the ER Because of Medications Read More »
Right away, let me say… You are not a bad caregiver if you can not get your person to take their meds every day! Think about it, do you take your meds every day? Do you take them on time, on the dot, consistently? Most people are not perfect with this. We are human. A
Dementia Loved One Refusing Daily Medications? Read More »
OK, let’s jump back in this week where we left off with Mistake #6. If you are looking for the first post with mistakes 1-5, you can find it here. 6 – Not Using Medical Order Forms When They Go Along with Goals of Care When your person can no longer speak for themselves, this
10 Mistakes to Avoid as Medical Power of Attorney – Part 2 Read More »
I can not stress enough how difficult it can be to make life and death choices for another person, especially someone you love. This is an incredibly important job. We know that people living with dementia are living with a progressive disease in their brain which at some point will make it so they are
10 Mistakes to Avoid as Medical Power of Attorney Read More »
If you missed Part 1 covering DNR (Do-Not-Resuscitate) order forms, you can find it here. Now let me tell you about my “beefs” with the Living Will. There are many. To start, Living Wills are not drafted by medical professionals. They are legal documents drafted by attorneys. As a legal document they vary in wording,
The DNR & Living Will Fall Far Short in Dementia…Part 2 Read More »
As an ER doctor, I see dementia family caregivers, and my patient’s in general, making a huge mistake when it comes to care planning. They misunderstand, and believe having a living will and a DNR (Do-Not-Resuscitate) form will be enough to guide them in making medical decisions. You can not use these documents alone when making
The DNR & Living Will Fall Far Short in Dementia…Part 1 Read More »
