Now that we are “between” the holidays, the staff notices the same phenomenon. Our office starts getting more calls about Medicaid Planning in the first few weeks of December than at any other time of year.

There is an easy explanation for this yearly occurrence. It’s one of the few times of the year when all of the “out of town” kids are back at the family home; and together they start noticing warning signs of what could be the onset of dementia in Mom or Dad.

They discuss the behavioral changes they’ve noticed — and what it means to the loved one and the family if it is Alzheimer’s or dementia. And once they research the costs of nursing home care, they decide to call our office to learn more about long term care planning.

Some warning signs of dementia include:

Lapses in memory

It may have been in the past few years that Mom or Dad had a few lapses in memory, but it was only a few small things that didn’t amount to much. But now it may be a lot more frequent, or at least more frequent enough that everyone is noticing. When my grandmother was in the early stages of dementia, she asked a lot of questions about how everyone is doing and what was going on with their lives, and we would answer her questions with an occasional repeat in questions. But soon, the questions were being repeated three or four times in the matter of an hour, and each time she covered it up by saying, “Oh, that’s right, you did tell me about that.” We knew something was changing.

Changes in living conditions

Another warning sign families may encounter is the condition of the house. Suddenly, the grass hasn’t been cut in a while, the bushes need trimming, and minor home repairs that were usually addressed immediately are now left undone. (However, please do not confuse this if the parents or grandparents have a list of things they would like you or your siblings to help out with. That’s not memory decline, but delegation, and it is actually a good sign if a parent is recognizing some physical limitations and is addressing them by asking for your help.)

Things that are out of place

Sometimes family members notice things being “out of place,” or behaviors that are out of character. For instance, unopened mail piling up may be a warning sign if Mom or Dad usually gets to the mail immediately. It is not uncommon for someone in the early stages of dementia to be unable to handle certain tasks related to bills, taxes, or other correspondence, or at least not address them effectively. And so they may simply ignore things until they get a phone call from a company representative.

The refrigerator and/or the pantry is another area that may cause concern. One colleague of mine described finding 50 pounds of potatoes piled up in his mother’s pantry. It wasn’t that she went out and bought 50 pounds of potatoes all at once, but she had gone shopping five times in two weeks instead of her usual once a week trip because she had forgotten several times what day it was. Each time she went shopping she purchased a ten-pound bag of potatoes.

Other things that are out of place may indicate more severe issues with memory and thought process. For example, my grandmother would frequently misplace things because she was simply putting things away in the wrong place. Not just the wrong drawer or shelf, but completely out of place. My grandfather told me that my grandmother had put the mail in the freezer, the coffee pot in the oven, and some cans of soup in their bedroom closet, all in the same day. Obviously, that was a lot more severe than these items turning up over the course of a week, but at this point my grandmother had already been diagnosed and steps were being taken.

Available resources

The warning signs inevitably lead to a lot of questions and research into cost. When it is discovered that the average cost per month is about $6,500-$7,500 per month for the basics, then we start getting questions about Medicaid Planning. This area of law and finance is so broad and complicated that we have compiled a few resources to help families get started by gathering some Medicaid Planning answers in a structured way:

If you are certain you need to speak to an attorney or Certified Medicaid Planner™ (I am both), then please call our office at 919-844-7993. We can set up a Medicaid Planning Strategy Session; and part of the pre-appointment packet will include my book The Long Term Care Solution.