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Successful aging: The issue of responsibility as you care for a friend’s well being

Q I recently went on our 20th annual female golfing trip with good friends ages 68 to 82 years. One of the women has very early stages of dementia. After I drove her home and walked her to the door, she found the front door locked and became agitated because she could not find her keys. Her husband was inside unconscious from drinking, and also bleeding. The police came to the rescue. This couple can no longer manage on their own. And they have a daughter who does nothing. I want to help. What is my responsibility?

— Y.R

A Dear Y.R.:

You have a dilemma. A caring knee-jerk reaction might be to take over the situation, which would include finding services, shopping, cooking, driving and supervising everything. Hopefully, that would be a momentary reaction.

Capitalizing on your long-term friendship, an initial approach would be to discuss your concern with the couple. Share your worries about their safety as drivers, or as chefs who might forget to turn off a burner. Address the perils of driving while under the influence. If alcohol is an ongoing problem, suggest attending an Alcoholic Anonymous meeting.

Ask your friend if she recently has seen a doctor to check on her confusion and whether she had a recent physical exam. If not, suggest she do so. Her memory changes could be caused by medications or she indeed may have mild cognitive impairment due to some brain dysfunction. A physician’s diagnosis and treatment plan would be in order.

Let’s assume the couple resists your suggestions. Perhaps the next line of attack is to contact their daughter. There is always the risk of appearing intrusive, moving into the private life of a friend and her family. From my perspective, that is a risk worth taking. Share your concerns and give examples of the problem.

The conversation might go like this:

“Jane, I am a good friend of your mother; we have been golfing buddies for decades. I am calling you to share a concern. Your mother is losing things, periodically gets lost and is quite confused, although her golf game has not suffered too much. We had a situation. When your mother arrived home from our all girls golf weekend she could not remember what she did with her keys, asked the same question over again and became confused. The police unlocked the door; your stepfather was on the floor drunk and bleeding. From my observation, your mother and stepfather are not able to safely manage their day to day life. Is this something that you might discuss with them and help develop a plan for their continued safety?”

If Jane is disinterested, there is not much you can do. Her parents have the right to self-determination. However, if they are a danger to others, that’s another story, which is particularly relevant to driving.

If you believe that either of them are no longer safe drivers, submit a Request for Driver Reexamination (DS 699) to the Department of Motor Vehicles to review their driving qualifications. The form which can be downloaded must be signed; a request can be made not to reveal your name. All records received by the DMV that report a physical or mental condition are confidential and cannot be made public unless mandated by law. They may be asked to take a written and on-the-road driving test.

Assuming the couple is somewhat willing to meet with someone, a program called Genesis from the Los Angeles County Department of Mental Health may work. Genesis is for those 60 years and older who have significant mental health problems that affects their level of functioning. The services and support are conducted in the person’s home.

The team consists of a registered nurse and a social worker who provides home assessments, physical evaluation, individual and family counseling, medication services, education and support and help in obtaining other services. A referral is required which may be from a friend, family member or professional. For more information, call 213-351-7284. Also check the Internet and look up “Los Angeles County Department of Mental Health Genesis.”

Y.R., thank you for sharing your story and dilemma. You indeed are a good friend. Hope these suggestions will be helpful.

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