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It’s a big milestone birthday, and you want to do something special, but there are some important considerations when planning a party for a person with dementia.

I recently helped a client plan their mother’s 90th at her assisted living community. Here are some guidelines and tips to we used to make it a success:

  • Keep it small. The guest list should only include close family or friends. Too many people will be overwhelming and cognitively over-stimulating. This could lead to disengagement, confusion or agitation. I recommend no more than 15-20 people. This is not the time to invite all the long-lost cousins. Although having similar-aged peers of the birthday person is helpful for some distant memories.
  • Plan an activity. Put together a retrospective photo-montage and show it on a big screen TV, not on a small laptop. Sit the guest of honor directly in front of the TV for viewing. Have all guests gather around and reminisce together to share stories and help the younger folks know who is who. Have a long delay on the photos to give adequate time for memories to surface and repeat the whole slide show on a loop. Take the time to find and scan old photos and vintage documents, too. You want to jog the memories of your loved one with photos from their childhood, not just your own.
  • Ask guests to share a story, or bring letters written by the birthday person that they can read aloud. Humor is always good.
  • Choose a menu of foods that are easy to eat and are favorites of the guest of honor. It is not unusual for the event to be distracting and therefore not much eating happens for the person with dementia. Pay special attention to offer beverages for hydration, and small bites of food.
  • Assign someone to pay attention to the non-verbal cues and behavior of the person with dementia so you can be aware when a bathroom break or quiet time might be needed.
  • Remind your guests in advance of ways to engage positively. For example when they arrive and greet the person with dementia, provide their name and context of who they are, rather than saying, “ Do you remember me?”
  • Lastly, pick a location that is easy, convenient and familiar for the birthday person. You don’t want them disoriented and agitated from a long car ride or unfamiliar environment.

With proper planning and the right environment, a birthday celebration for a loved one with dementia can be a stress-free and joyous occasion.

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by Joan Garbow, MSW, LCSW, CCM
Advanced Member of The Aging Life Care Association

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When families contact me for help and planning, one of the concerns expressed is the rapid depletion of funds while paying for care.  It is a complex problem to solve.

The reasons for this unfortunate situation vary from a lack of adequate retirement savings, low income, or unfortunate decisions about investments and real estate purchases, or inability to live within a realistic budget. There also could have been too many gifts or transfers of assets, or financial exploitation.

Sometimes adult children are paying for care or supplementing an elder’s monthly expenses. There could also be a large debt accruing due to a gap in adequate personal funding. One recent client owed the town close to $500,000 in deferred taxes. Another owed an assisted living facility $100,000 due to a conflict in the family over selling the parents’ home which they were no longer residing in. A daughter of another client was not able to save for college or her own retirement due to paying over $5000 per month for her parents’ care in an assisted living community. At some point, those facing these types of challenges realize it is unsustainable.

There are a few ways to help fund care and try to solve this kind of crisis. One is to explore eligibility for state funded homecare through Medicaid. Also, determine if the elder could be eligible for the VA Aid and Attendance program for Veterans who served during a wartime period, or their surviving spouse. The application process can be a bit overwhelming, but the benefit is worth the effort. There are paid consultants who can help navigate the system and streamline the process. There is also a Reverse Mortgage option if the elder lives in the home and there is adequate equity available.  These programs can help fund part-time care in the home, but would not usually be enough to fully fund assisted living costs.

As a last resort some individuals who cannot afford their care must consider skilled nursing home care and apply for Medicaid for funding. In this situation I recommend working with an elder law attorney who can advise about preparation and planning for this application.

However, if your elders are not yet in need of care, now is the time to start planning to ease the headaches down the road.

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by Joan Garbow, MSW, LCSW, CCM
Advanced Member of The Aging Life Care Association

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