Toronto Star

Caregiving husband needs doctor’s assessment

- Ellie Tip of the day Discuss Power of Attorney and caregiving options well before they’re needed. Read Ellie Monday to Saturday. Email ellie@thestar.ca or visit her website, ellieadvic­e.com. Follow @ellieadvic­e.

Dear readers: A family’s fears regarding a husband’s inadequate caregiving for his wife with dementia brought many responses regarding vulnerable seniors — a topic that also affects younger relatives as decision-makers (April 18): Reader No. 1: “It’s possible that the husband (age 80) may be experienci­ng cognitive impairment­s of his own, or physical issues, that may affect his ability to care for his wife.

“Their sons should encourage him to see a physician regarding his own health. He may be simply overwhelme­d by the caregiving demands. He may believe that he’s solely responsibl­e for his wife’s care, though there may be other avenues open to him.

“In Ontario, Community Care Access Centres (CCACs) can offer access to additional supports at little or no charge. (Ellie: Similar agencies can be sought in other locales). These include help with bathing, laundry, adaptation­s to the physical environmen­t, etc.

“So the woman’s concerned sisters may contact the local CCAC. The husband may find it more acceptable to have a third party involved rather than having immediate family tell him that his care is inadequate.

“If he’s concerned that his wife may be taken away, current waiting lists for long-term care (indicate that) a situation would have to be extremely critical (for that to happen), plus there would have to be agreement with the decision-maker.”

— From a registered nurse who’s been involved with both sides of similar situations. Reader No. 2: “The husband’s abilities and judgment should also be assessed by a doctor.

“It’s highly unlikely that the wife is fed, given regular exercise, mental and physical, and have all hygiene needs attended to.

“Reusing diapers will eventually cause skin breakdown sooner or later.

“The public health department in the area might be able to help also.

“The Alzheimer Society does provide visitor or respite care to families caring for a loved one, in some areas.

“It’s possible that this man will be unable to continue, so contingenc­y plans should be made.” Reader No. 3: “Besides CCACs there is also, in Ontario, an Office of the Public Guardian and Trustee (OPGT) regarding situations like these.

“They may be called upon to assess the wife, and the husband’s capacity to help her, or initiate other actions to assist her.

“If the husband’s found to be incapable as a substitute decision maker, then her sons may become her decision-makers and can begin to legally act in her best interest.

“Even without an assessment of the husband, since the sons have Power of Attorney, they’re her substitute decision makers for personal care, not her husband.” Reader No. 4: “The Alzheimer Society has terrific programs for dementia patients. The concerned sisters should attend one of the informatio­n sessions to get advice and maybe convince the husband to go to a session.

“They were a godsend for our family!” Reader No. 5: “As a lawyer, a significan­t portion of my practice is now known as ‘elder law.’

“The husband’s refusal to involve outside care for his wife isn’t unusual.

“It arises from a variety of causes, such as, as Ellie noted: Concern about cost, inability to accept the aging process in one’s self or spouse, inability to recognize the poor quality of care and fear that the spouse will end up in a care facility, leaving the other spouse “home alone.” Or a combinatio­n of those.

“Advance care planning is very helpful before cognitive functions decline to the point that fears take over.”

“This family should’ve had discussion­s years ago.”

He may believe that he’s solely responsibl­e for his wife’s care, though there may be other avenues open to him

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