If your client is having trouble paying bills, I suspect he's having trouble with other life management issues. Unpaid bills can often be a symptom of a medical problem in an older adult. Depression, drug interactions, a mini-stroke or even a urinary tract infection can present with the symptom of confusion or memory loss. It is a good idea to suggest a thorough medical exam with a practitioner who regularly treats older adults. If a physical problem is ruled out, the physician can also do a mental status evaluation to determine if the client might be in the beginning stages of an Alzheimer's-type dementia. There are several medications that can be effective to mitigate some of the symptoms of memory loss. Often seniors with early dementia are also depressed, so it is useful to have a neuro-psychiatric evaluation done so that proper treatment can be started.
Some other questions come to my mind about this gentleman who is forgetting to pay his bills. Is his nutrition adequate? If he is forgetting to pay bills, the chances are that he is not eating well. Would he know what to do in case of emergency? Is he at risk of falling in his home? If he has a car, is it safe for him to be driving? He should have a power of attorney and a living will, in case someone needs to make decisions on his behalf.
It would be important to assess whether or not he takes his medication and if he is receiving ongoing medical care. We would be concerned about his social interactions and support system in the community. These are just some of the things that we try to assess when we are visiting someone for the first time. Often children who live out of town are not able to “see” the day-to-day problems of their parents. There is a tendency for both generations to minimize their concerns. When there is no crisis, it is easier to think that “if dad says he is fine, he must be okay,” since he was always so independent and in charge of things.
As a care manager who often has to respond to crisis situations where an elderly person has fallen or perhaps started a fire in his home, I am always glad when families are able to contact us before there is an emergency. Early evaluation can identify problem areas that might be addressed with minimal supports, such as a few hours of in-home care, help with bill paying, an emergency response system or perhaps Meals on Wheels, to name a few.
|
