Care consultations

We begin with a realistic scenario for the counselor: You have been called for help after a family has experienced the grave difficulty of confronting dementia in a parent, sibling or relative. This chapter discusses the family context within which our later chapters on detailed legal solutions will be presented by the attorney.

Diagnosis of dementia in a loved one brings slow heartbreak, and experience with that sad event carries this message to family members: “Don't try dealing with this alone!” Yes, counselors say, life is unfair, but you must “get over it,” and assume the helper role that your loved one needs for you to perform. Each dementia patient will need multiple caregivers, allies and respite care providers for those caregivers. This requires a family's close attention to their newly discovered responsibilities. “It takes a village” for a family to come out of the dementia experience with a positive unity among the family members.

Though each case is different, the patterns can be recognized and responded to by experienced nurses and social workers. The diagnosing physician is likely to hand over the dementia patient's continuing oversight of care to the nurse or the psychiatric social worker. Dementia specialist social workers start with gathering information for the Care Consultation. This event is a “summit meeting” of those who care enough to be supporting the patient in the face of the dementia diagnosis.

Because the dementia patient can be expected to live several years with the brain degeneration process under way that can lead to death, social workers help that family to understand the stages and the process that they are entering. “Build a Foundation for the Future” is their theme in dealing with the family.

Social workers will meet with the patient's family to set up short-term and long-term goals. What is needed for this patient now? What is likely to be needed in her or his future care? How much will it cost? How will we allocate the care roles and the funding needed?