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How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
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Acknowledgment of Disclosures and Authorization
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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As has already been stated, first you need to find out whether there is a simple, treatable reason someone can't chew/eat such as dental problems, dry mouth, difficulty swallowing certain textures (dysphagia)
Feeding tubes are a great option as a temporary measure until someone heals enough to have it removed - after a stroke for example. They are also life savers for people who have a chronic condition that prevents them from eating normally - like someone who has battled throat cancer. In my opinion (and numerous studies back me up) when someone shows no interest in eating due to a terminal illness - and remember that dementia IS a terminal illness - you are doing them no kindness by begging them to eat or forcing food in any way. This is an emotional issue because food is often associated with love and nurturing, but there comes a point where you may be doing more harm than good. They truly aren't hungry and they can't tell us any more obviously that they are transitioning to end of life.
Removing nutritional support isn’t “usually just done when the person is vegatative or comatose” and removing is NOT a form of euthanasia. It is also done when the body is shutting down and can no longer digest food. If you force feed a dying person through a feeding tube, you aren’t doing them any favors. Sometimes you are only prolonging the inevitable. If their body is shutting down, you are actually causing them great discomfort because their stomach is full of food they can’t digest! This happened to my MIL and everyobe thought she was just constipated. But before you make any decisions, unless she’s on hospice, you need to have her evaluated by her doctor at the very least! With her disease, the inability to swallow is not usual.
There's a big leap between not chewing and swallowing and a feeding tube. What has she been eating up til now, has she had a modified diet at all - minced moist or pureed? And has she been evaluated by her doctor or a speech and language pathologist?
At your Moms age I would not allow a feeding tube.
This could be the start of Moms body shutting down. You could have her evaluated for her swallowing. But I suggest you call her doctor and run this by him. He may suggest its time for Hospice.
My grandmother lost the ability to eat by mouth. First, we responded with a liquid nutrition option, lots of proteins and thick liquids, which fixed all hydration issues, too.
She progressed further in her disease, and after a family meeting, a nasogastric feeding tube was agreed on, as opposed to a tube surgically placed in her belly. When you say you don't want a feeding tube, do you mean any feeding assistance, or only a surgically placed tube?
She was far enough gone where she would not fight the nasogastric tube insertion. Using a syringe to add medicine via a feeding tube is not very scary, and caregivers can be trained to properly monitor or even insert a tube depending on their professional level. You can feed someone while they are sleeping.
There are nurses and nursing services who prefer nasogastric tubes to surgery, as well: https://www.acsh.org/news/2016/06/14/nursing-homes-forcing-surgery-on-the-ill-and-elderly
Removing nutritional support and letting someone die is a thing that is done, usually when someone is vegetative or comatose, though. If you think the caregiver is hinting at euthanasia through removal of nutrition, get clarity immediately. If that is an option for your family, you'll want to make plans with legal advice from someone who is versed in end of life issues to make sure any nutritional removal you engage in is done in accordance with law and palliative care standards (such as being paired with opiods to dull suffering and overseen by a hospice nurse.) End of life options are there, as well as medically more invasive options to prolong life.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Feeding tubes are a great option as a temporary measure until someone heals enough to have it removed - after a stroke for example. They are also life savers for people who have a chronic condition that prevents them from eating normally - like someone who has battled throat cancer. In my opinion (and numerous studies back me up) when someone shows no interest in eating due to a terminal illness - and remember that dementia IS a terminal illness - you are doing them no kindness by begging them to eat or forcing food in any way. This is an emotional issue because food is often associated with love and nurturing, but there comes a point where you may be doing more harm than good. They truly aren't hungry and they can't tell us any more obviously that they are transitioning to end of life.
This could be the start of Moms body shutting down. You could have her evaluated for her swallowing. But I suggest you call her doctor and run this by him. He may suggest its time for Hospice.
She progressed further in her disease, and after a family meeting, a nasogastric feeding tube was agreed on, as opposed to a tube surgically placed in her belly. When you say you don't want a feeding tube, do you mean any feeding assistance, or only a surgically placed tube?
She was far enough gone where she would not fight the nasogastric tube insertion. Using a syringe to add medicine via a feeding tube is not very scary, and caregivers can be trained to properly monitor or even insert a tube depending on their professional level. You can feed someone while they are sleeping.
There are nurses and nursing services who prefer nasogastric tubes to surgery, as well: https://www.acsh.org/news/2016/06/14/nursing-homes-forcing-surgery-on-the-ill-and-elderly
Removing nutritional support and letting someone die is a thing that is done, usually when someone is vegetative or comatose, though. If you think the caregiver is hinting at euthanasia through removal of nutrition, get clarity immediately. If that is an option for your family, you'll want to make plans with legal advice from someone who is versed in end of life issues to make sure any nutritional removal you engage in is done in accordance with law and palliative care standards (such as being paired with opiods to dull suffering and overseen by a hospice nurse.) End of life options are there, as well as medically more invasive options to prolong life.