Hi All,
If your parent(s) have taken the St. Louis University Mental Status (SLUMS) test by a healthcare professional to detect early signs of dementia and mild cognitive impairment, and scored in the 0-20 range, what planning happens next?
My father wants to take the test again in 6 months to compare his scores, but I’m afraid at that time, the score will either be the same or lower. Both mom & dad scored lower than 20. The doctor was not present at the exam, so according to my dad, the scoring system was not explained, nor was their individual score. Is that explanation the doctor’s responsibility, not the nurse or assistant who gave the exam?
Dad, mom & their dog live in an independent retirement community, with only 8 assisted living units available, which all are occupied today, and no memory care units. They are a happily married couple of 63 years, taking care of each other as best as possible with each of their physical (& now mental) health issues. Family is nearby to visit & assist weekly, if not every other day. I am open to ideas, especially on how to work with their cognitive impairment.
Thank you….
Medically - getting the doctor's thoughts on the score would be nice to know. Are they recommending a neurologist, PT, OT, etc. is a good entree to getting that response. I know several family members have taken SLUMS test and we've always gotten an answer (along the lines of - there's age-appropriate decline and here are things to consider going forward) rather than a score.
Yes to the POA and MD moving to younger people as first and second. (You do NOT want hospitals making decisions for your family.) My parent gave me permission to speak with their attorney - I promised I would not pry into specifics. The only questions I asked dealt with: How can my folks get ahead of stressful situations given how their estates are set up if one of them becomes incapacitated? Specifically, if one or both of them are experiencing significant cognitive decline? Their attorney had immediate solutions for them.
Get their phone passwords because all those dual-factor notifications get sent there.
Work with them to set up a spreadsheet of passwords and accounts (banks, social security, retirement). My attorney has been on me to do that since I was in my 40s. I just did it with my parent during a crisis situation with the other parent and still haven't done it for myself.
Planning ahead can make the really hard times ahead be a little easier.
Perhaps they can begin with some in-home care? My husband's beloved aunt had nieces and nephews coming to stay and help and some in-home care as well. We would sign up for times and cook meals and clean. That can buy you time and keep them most comfortable and safe at home until they're ready for the next step.
If you're fearful of them getting lost and want to reduce their anxiety over misplacing important things - Air Tags on keys, in wallets, trunk of car, and under shoe insoles.
You're very smart to be planning ahead.
Advance healthcare directive, also called a living will, should be filled out and on file with their doctor and uploaded to their healthcare system patient portal, where applicable. This document details what kind of medical treatments they do or do not want, and designates one or more people the doctor's can speak with.
Medical Power of Attorney (POA) can overlap with advance directive but is often prepared by an attorney, and even if not done by an attorney should be notarized. The POA should have their own copy. So many people prepare these documents and then lock them in a safe or bank vault. They're useless if no one can get at them.
Financial POA designates someone to have access to and control over property, bank accounts, investments, the phone bill, etc. This doesn't mean you lose control of your own assets, it means you have someone with legal authority to handle your assets when you're no longer capable.
When a couple is younger they generally designate each other as POA, and the back up might be a sibling or someone else their age. My kids are teens, they are obviously not designated as our backup POAs but when we are older we will change that.
Take your parents now to fill out these documents. Find an attorney with good people skills! Someone who can explain these documents as something every smart person should have, and aren't they wise to be getting this done.
If you already have these then of course ignore my ramblings. Folks can advise you on next steps after that.
I do know that after taking the SLUMS test, mom & dad did not want to fill out the POLST form - direct instructions for emergency responders, a DNR, signed off by the doctor at an appointment. The directive is in their Trust, but for whatever reason not yet discussed with us kids, they both didn’t want to fill out the form. The dementia, I know.