Shay Jacobson, RN, MA, NMG, LNCC, CLNCP
Martha Kern

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Anita was, by all accounts, a very pleasant woman. She participated in all of the facility’s social outings and taught the other residents how to knit.

She could not, however, tell you her name on a consistent basis, nor did she always know which room was hers.

She remembered only tiny bits of distant history, some long-ago family associations, a few places she might once have lived.

She could not tell you how she’d come to be in this Assisted Living facility.

Mysteriously, neither could anyone else.
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How Did I Get Here?
Anita’s presence at the Assisted Living Facility was somewhat of a given. She had always been there, since the place opened over a year ago.

The staff had turned over. Those who might have been there when she arrived, who might remember something about the circumstances of her admission, had moved on.

The file revealed only that she had been “dropped off by a neighbor”. It also stated that she was initially referred by a home care company and had recently sold her home.

And now here she was, rapidly losing ground to early-onset Alzheimer’s, with no visitors, no known associations, not a person in the world who would stand up and say, “Yes, I know her,” or “I can act on her behalf”.

Anita was in a vacuum.
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Lost Connections
Memory loss can be tragically compounded when it is layered atop an isolated life. Those who have become estranged from family, perhaps, or who have withdrawn from the world due to depression, come to live alone and with very little social contact. As the cognitive decline mounts, there is no one there to see it. There is no one to intervene and help.

It is not unusual for people in Anita’s predicament to get help only as the result of a public crisis.   They are found wandering on the side of the road. They knock on doors in the neighborhood, having lost track of home. The police are called. A hospitalization ensues.

And then we are called to begin the work of bringing things under control, restoring order, often in the form of guardianship.

In Anita’s case, a former neighbor had intervened in the form of a ride to the facility. All the while she lived in this communal environment, Anita had shelter, three daily meals, and access to care providers who could gently steer her toward the right apartment.

As Anita’s cognition worsened, the facility’s sense of risk deepened. She was paying her rent each month (when prompted) though clearly would come to a point where she could not manage this task. Whatever service agreement she had signed on admission may or may not be valid, given her possible lack of decisional capacity even as she entered the facility.

The facility was in the untenable position of being generally responsible for someone about whom they knew very little, and for whom they could not legally be responsible.
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Risk Averted
Eager to protect both Anita and themselves, the facility moved forward with a petition to name Lifecare as Anita’s Guardian. We can ensure that Anita’s needs are properly met in her current environment, advocate for her should she ever be hospitalized, consent to procedures, solve day-to-day problems and in every way assure her safety and wellbeing.

We often tell our partners in the senior community realm not to put their organizations at risk by admitting a resident under his/her own signature when their level of decisional capacity is in question. If there is no agent under the Power of Attorney to sign the agreement or co-sign with the resident, and the client seems incapable of understanding the details of a contract, an assessment is in order, and perhaps consideration of guardianship.

Lifecare Innovations is also happy to act as agent under the Power of Attorney for those who lack good candidates in their lives but who still retain adequate executive function to execute the document. Many a prospective guardianship has been averted in this way.

We will do our best to learn Anita’s history, perhaps track down relatives and fill in the gaps of a life forgotten. We will be the steady presence Anita will need as she transitions through the stages of her illness, and perhaps transitions to a higher level of care.

We will do our best to make Anita a person who is known and in every sense, found.

©Lifecare Innovations, Inc.