Elaine Vlieger had been her late husband's caregiver during a long illness and knew the importance of that planning. After her Alzheimer's diagnosis 18 months ago, she designated power of attorney and who will help make her health care decisions, and added a son to her bank accounts.
For day-to-day living, Vlieger makes reminder lists. A friend accompanies the once avid hiker on a daily neighborhood walk, and neighbors check on her. She's considering wearing a monitor to call for help if she falls.
Transportation is a key part of planning care for people with Alzheimer's. Vlieger insists her driving is fine, and sticks to small, familiar roads and avoids rush hour as a precaution. Daughter-in-law Marla, however, says the doctor wants her to quit.
The younger Vlieger says her mother-in-law generally copes well but is finding it harder to handle the unexpected. Family members get tearful phone calls over small crises such as a toilet overflowing. Email has become frustratingly hard because the provider updated the program so it no longer looks familiar.
Then there's the planning about housing.
"The family was split," Elaine Vlieger says.
One son is researching assisted living options, but Vlieger protests, "I'm more active than those people are. It makes me feel old when I go in there."
She likes her daughter's suggestion of in-home services that could be added over time. Daughter-in-law Marla wonders if a geriatric care manager could offer professional advice "to help us decide what we need, and when we need it."
The trickiest part, Kallmyer says, is when to overrule someone with Alzheimer's and start making decisions for them.
"Alzheimer's is not a linear process. Somebody has a bad day and the next several days will be good," she says.
Elaine Vlieger has started cleaning out her home of 35 years. But she says firmly, "I am not in a hurry."
Alzheimer's Association: http://www.alz.org
National Alzheimer's Plan: http://aspe.hhs.gov/daltcp/napa/NatlPlan.shtml
Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
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