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Five Facts About Dementia Caregiving in Louisiana

Dementia, in particular, the prevalence of Alzheimer’s Disease in the American population, is creating difficult caregiving experiences for the family members who are primarily responsible for providing care. Even though you understand your loved one’s dementia behaviors are a symptom of the disease and not intentional or personally targeted to you, coping with them is often emotionally, financially, and physically challenging. Psychology Today reports caregivers routinely say, “Nobody really understands how hard caring for a loved one with dementia is!”

First Fact: Most Care is Provided to Someone with Dementia

Psychology Today is also reporting five facts that you should know about dementia caregiving, particularly since its incidence is increasing in the United States. The first fact is nearly half of all people who provide care do so for someone with dementia. The statistic is 48 percent of caregivers are providing for those who have Alzheimer’s Disease, Vascular Dementia, Lewy body dementia, and more. Additionally, dementia is typically not the only ailment a loved one suffers from, and dementia can have long phases from preclinical to its last stage, making caregiving a long-term commitment. The complexity, hours, and level of care needed throughout the stages of dementia are staggering.

Second Fact: Most People with Dementia are Not Living in Nursing Homes

A second fact about dementia caregiving is that most people with dementia are not living in a nursing home or assisted living but rather with a family member. Most Americans aged 65 or more live in the community, with only about 4.5 percent (roughly 1.5 million) of older Americans living in nursing homes and 2 percent (1 million) in assisted living facilities, according to the National Institutes of Health (NIH). These home care providers are more than two-thirds of women (67 percent), and more than one-third of these are daughters.

Third Fact: Care Requirements are Needed 24/7

Dementia, in particular Alzheimer’s, is the most expensive disease in America, costing more than heart disease and cancer. This third fact is unsurprising as care requirements are often needed 24/7 for years. The Alzheimer’s Association (alz.org) Fact Sheet reports that in 2020 caring for those with Alzheimer’s and other dementias cost American society an estimated 305 billion dollars. While much of this cost is born through Medicare and Medicaid spending, for caregivers, there is still an out-of-pocket expense that is nearly twice that of caregivers providing care for other conditions. Caregiver payouts can include medical care, personal care, respite care, household expenses, and more.

Additionally, the rate of progression of dementia disease varies widely. On average, a person with Alzheimer’s will live between three to eleven years post-diagnosis. Yet there are some cases where patients survive twenty or more years. Typically, a caregiver for a loved one with dementia will provide care one to four years longer on average than caregivers of other conditions.

Fourth Fact: Dementia Caregivers Work Multiple Hours a Week

The majority of these dementia caregivers are still working in formal employment. The fourth fact is 60 percent of dementia caregivers are working about 35 hours a week. Dementia caregivers are pushed beyond normal limits to provide a loved one’s care nearly 24/7 while still maintaining roughly full-time work. Since an average dementia caregiver spends over eleven thousand dollars a year out-of-pocket providing care, there is little wonder about the necessity of almost full-time employment.

Fifth Fact: Dementia Caregivers Tend to Experience Stress and Anxiety

Finally, the fifth fact is that dementia caregivers suffer higher rates of stress, anxiety, and depression than caregivers tending to other medical problems because of their enormous workload and responsibility. Dementia caregivers also experience more health problems than those caring for other medical diagnoses. It is easy to understand this is the case due to the high-level of caregiving, nearly full-time work, and expenditures that are expected of them.

These five facts about dementia caregiving outline the need for caregiver resources and encouragement. Dementia care providers must tend to themselves during their journey of caregiving to persevere. If you know a dementia caregiver or have one in your family, consider what they go through as it is profound. Listen to their stories. Ensure they receive education about the best ways to approach their intense workload and help them identify national and local resources. Community support and understanding are essential for success in a dementia caregiver’s journey.

If you or a loved one has been diagnosed with dementia, we can help navigate how to find appropriate care, how to pay for it, and how to protect your home and savings. We welcome the opportunity to talk with you further, please contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your planning needs.

Do You Understand an Advance Directive?

Kevin stands at the door of Winnie’s nursing home room, tears streaming down his face. The medical staff just finished inserted a feeding tube into Winnie – an act Kevin knew she didn’t want. Unfortunately, Winnie couldn’t express her wishes due to advanced dementia, and she had no legal documents that expressed her wishes not to be fed by artificial means.  Kevin had no choice but to sit back and watch his wife go through a procedure she didn’t want.

The situation with Kevin and Winnie could have been avoided through the use of proper advance directive. An advance directive is actually a collection of documents. What that includes differs depending on your needs and wishes, along with what the law allows. However, it usually means at least a Living Will, and a Power of Attorney for Healthcare.

The purpose of this set of documents is to allow you to control what happens to your health care in case you cannot speak for yourself. If certain criteria are met, your doctors must consult with your advanced directive before making decisions about your care.

Usually, what this means is that two doctors agree that an individual is terminally ill, permanently unconscious, or at the “end-stage” of a condition. Once that happens, and the individual cannot express their preferences, doctors turn to the advance directive to figure out what the individual wants.

A Living Will determines what happens to an individual making it, unlike a Last Will and Testament, which determines what happens to their money and possessions. A Living Will describes what healthcare providers can and cannot do to prolong your life and/or ease your pain when you cannot express those preferences yourself. For example, do you want to be placed on a ventilator if you cannot breathe on your own? Do you want a feeding tube and IVs set up, and if so, for how long? Do you want to be an organ or tissue donor?

A Durable Power of Attorney for Healthcare lets you choose someone to make healthcare decisions for you when you cannot. They still must follow your Living Will, but they will be able to make decisions not explicitly considered by your Living Will, in accordance with the facts of the situation. In most states, there are “default surrogate consent laws” which allow family members to make treatment decisions on your behalf, but who is chosen to make these decisions and what they choose to do may not be in accordance with your wishes, as it hopefully would be with a Durable Power of Attorney.

Other documents may be part of an advance directive by law, or they may be worth including on your own volition. These include Do Not Resuscitate orders and Physician Orders for Life-Sustaining Treatment, among others. You might also consider an advance directive in case of a mental health crisis.

This is a difficult subject to consider, and it always seems like it won’t be necessary. But nearly 70 percent of Americans don’t have plans in place for a worst-case scenario, which means for some of them, decisions may be made for them with which they would not agree, if they had the capacity to choose. For that reason, it is worth thinking about implementing an advance directive even if it seems unnecessary now.

If you or a loved one would like more information about advance directives, please don’t hesitate to reach out contact our office by calling us at (318) 255-1760.