When is it Too Late to Plan?

Last month we lost one of our clients to an unfortunate accident.  John  was suffering from the early stages of Alzheimer’s Disease and living at home with his wife, Mary (not their real names).  Mary was 20 years younger than John and still working to support the couple.  We had begun to long term care plan and recommended a part time home health aide for John while Mary worked.

 Early one morning, while Mary was still asleep, John awoke to use the bathroom.  The progression of the disease had recently caused John to become increasingly unsteady on his feet and he had experienced a few minor falls but he was resistant to using his cane.  When Mary awoke, she noticed the bathroom light on.  When she went to investigate, she discovered John in the bathtub.  He probably lost his balance, fell in the bathtub and died from the blow to his head.  The news was devastating.

 Could this tragedy have been prevented?  Did we, as counselors to John and Mary, do everything we could?  Certainly, a situation like this one calls out for the use of a Personal Emergency Response System (PERS) or Medical Emergency Response System (MERS).  (Life Alert is the one most people know.)  These systems enable seniors, in the event of emergency, to contact a call center which in turns notifies the police, ambulance or fire services. The senior wears the device as a wrist bracelet or necklace pendant.  It is impossible to say whether John would have had time to use it in this instance.

 There is, however, a broader lesson here.  When we talk with clients about planning for long term care, especially with families that are already in crisis mode, their focus is usually on the here and now, which is certainly understandable.  What services or assistance does Mom or Dad need right now?  What most fail to realize, however, is that the level of need is anything but stable.  What Mom or Dad needs now isn’t likely to be what they need 6 months or a year from now.  But there isn’t a set schedule as to when those care needs will increase. It won’t be the same for everyone.  And there won’t be anyone tapping you on the shoulder to say “now is the time to move to a safer environment”.

 We so often talk with families about getting the appropriate level of care.  It might mean in home care.  It could be selling the home and moving to a facility.  It’s never easy to hear, usually frightening to consider, and often the issue of cost is a primary obstacle.  The failure to adapt, however, can have serious consequences, as we saw in John and Mary’s case.  It is best to be “ahead of the curve”, not waiting for something to happen and then reacting to it.  Tragedies can be avoided and financially, a better result is the outcome as well.

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