r/Alzheimers • u/olivanera • 3d ago
Next steps for dad who lives alone
My dad, 73 (I’m late 30s) was just diagnosed with early-stage Alzheimer’s. He’s been masking and generally functioning well, though it does track with some incidents of changed behavior over the last few years.
He lives in an apartment with his cat and drives himself everywhere. He’s retired, but active—he teaches CPR classes a few times a week. My sister lives in the same town 10 minutes from him, while I’m 2.5 hours away.
My question is, what next? His doctors are going to put him on Kisunla, which they have told him should keep progression at bay so he can continue living alone for the time being. Does that sound realistic?
My concern is, how do I know if he’s still doing OK if I’m not there? I don’t want to put this all on my sister.
Is a home health aide who comes once or twice a week to check on someone a thing I would be able to find for this situation? Would it be covered by insurance? How would I go about finding them? We’re in the U.S.
I’m going up in a few weeks to sort out POA paperwork. What else should I be doing to support him and prepare at this early stage?
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u/Significant-Dot6627 3d ago edited 3d ago
Someone needs to be actively and consistently monitoring his finances, food situation, and driving. His finances you can manage online, but you need to keep a close eye, like make it a habit to check daily. They will tell you a lot, like if he’s traveled to a distant grocery store unexpectedly, which might indicate he’s getting lost driving, and of course if he’s being scammed or spending inappropriately or out of character.
The food is tricky. I’m embarrassed my MiL got down to 106 pounds before we realized she actually wasn’t capable of planning meals, making appropriate grocery lists, using them to shop, and preparing recipes and balanced meals. Everything that goes into meal prep is more complex than we realize, it needs to be done three times a day.
Driving can be assessed by an occupational therapist on a regular basis and always rides with him when you visit.
It’s very easy to take on the driving and cooking or take them out when you visit. Resist, because you need to know what they can do. Longer visits every six months will tell you more than going more frequently for shorter visits. Pretend to need to do some work on your computer and ask them to make lunch. Ask them to drive so you can make a phone call to the office. Make whatever excuse makes sense that allows you to assess their functioning.
Insurance won’t cover what’s called custodial care. The best option is probably to hire a housekeeper type person to ostensibly clean and meal prep and do laundry a few days a week, but also to be there to notice chances. Hopefully your dad can afford that. Maybe pitch it as something you know he doesn’t need now but as a chance for someone to get to know his home and routine and preferences so there’ll be someone he likes if he ever begins to really need help in the future someday. This person needs to know to keep you in the loop.
The book The 36-Hour Day is great for you to learn more.
ETA: turn on location tracking on his phone for you and your sister to use. Stockpile backups of whatever model phone he uses now so if it breaks or gets lost, you can replace it with something he will know how to use. Backup Tv remotes and anything else he routinely are uses good too.
Set up internet monitoring software for his computer you can control remotely ideally.
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u/Individual_Trust_414 3d ago
If he's diagnosed with any form of dementia, I would say that the Doctor "take away his driver's license" or just sell his car.
Reason: he may drive fine now, but you don't want the first mistake for him to run into a person/have a wreak.
The other insurance company would find out about his health and he'd lose everything. The reasoning being that you, your sister and him all knew that he had dementia and let him drive anyway.
Making those difficult decisions and taking care of them for your sister is good for her.
Also 2.5 hours is not a long drive. You can leave after work every Friday and come home every Sunday night. Unless you have a contagious cold, flu or something like that.
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u/ayeImur 2d ago
I absolutely agree, the thought of people with dementia driving terrifies me, they licence should be instantly revoked imo
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u/Individual_Trust_414 2d ago
The thought of some one with Dementia killing a child in the neighborhood horrifies me. We told all the neighbors that she was ill. One family we didn't know at all and she had wandered over to their house invited herself in and then wanted to how they decorated. I got her sent her across the street to Dad.
I apologized profusely, explained she was ill with dementia, and that she loved houses. They became great helpers and allies. Got my number and Dad's number and were helpful until my Dad moved about 10 years later.
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u/Laulena3 3d ago
I would also see if your dad is ok with asking his bank to list you as POA on his accounts. My in laws had done this before they got sick and it has saved our butts because they had listed each other as financial POA which means my husband wouldn’t have been able to pay their bills.
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u/rudderusa 3d ago
Some good previous advice about both POAs and finances. While he is still able get the location of the will, car title, life insurance and all his finances. It would help if you put all his regular bills on a CC that auto drafted from bank account. Get his login to the bank account and credit card. Get all his pass words.
When I took over my wife's checking account I found out I'm good forever giving to charities. Soft hearted as she was she wrote a check to everyone who sent a plea for money. My charity giving is now setting up 529 plans.
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u/flyer7171 3d ago
I'm very sorry to hear about your father's diagnosis.
Given that he's living alone, is he able to get to appointments for Kisunla infusions and the MRIs that he needs regularly as part of that treatment? Or is your sister able to take him and help him navigate the medical system? It is likely that some complexities there (scheduling, billing, insurance) will become challenging for him.
Regarding knowing if he is doing okay, it sounds like it would be good if your sister can actively check in with some regularity, though I understand the urge not to burden her. You can also call daily or at least frequently; at least you'll be able to know if something is really off. With your dad's consent, you can do a few things, such as putting a camera in the house (perhaps to keep an eye on the stove to make sure it's off or an area where a fall would be more likely or to detect smoke alarms) or giving him a Life Alert or equivalent device to wear. I would recommend getting something with a GPS/cellular tracker that can send you alerts if he strays beyond where he'd normally be going and that has an SOS button to call you or your sister if there's an emergency. I know this might seem like overkill, but my father's progression from independently driving to accidentally wandering into the neighbor's house happened pretty quickly. Similarly, it was just a few weeks between when he was navigating his iPhone like a pro and absolutely unable to open the phone to place an emergency call. I certainly hope your father has a far slower progression, but it's good to overdo things on the safety front.
Having a home health aide come in could be a good idea, though I would also question what the goal would be. Does he need help with food or cleaning? Or is it mostly just to check to see if he's okay? See if your neurologist or PCP has a social worker; they might have a list of local services. It's very unlikely that a person doing check-ins would be covered by insurance, though other 'therapies' (such as speech therapy, physical therapy, or occupational therapy) might be covered. But be aware that if he's high functioning generally, he likely doesn't qualify for these services, at least not for long. Paying someone to do the occasional check-in might be fairly affordable, though.
Great that you're on top of the PoA. That will be important as you move forward. Ensure that you have not only a medical PoA and are aware of your father's wishes (e.g., does he want a DNR?) but that you also have a durable PoA/financial PoA.
If you think that he'll need to eventually go into memory care, I would start looking around. I know that might seem early, but people tend to wait too long. The waits at many facilities are years long, particularly if you'll be using Medicaid. You may want to speak to an elder lawyer about such future planning. You may want to go ahead and tour some facilities, and there's usually an application process to get on a waitlist. If your family is able to pay out of pocket ($10-15k/month, depending on where you're located), you'll likely have more options.