By Nicholas Wilbur

Albuquerque this April will play host to the 26th annual National Association of Professional Geriatric Care Managers. As part of the weekend-long series of events, an estimated 300 care managers who are leading the way in elder care will offer their expertise on a range of services, including counseling, home care, psychotherapy and guardianship.

Lectures will cover a wide range of issues, including how to deal with highly demanding clients, retooling practices in order to meet growing multicultural needs, “The Myth of Alzheimer’s: New Stories in Brain Aging,” and a review of care management principles and practices.

In addition to the general and breakout speakers, this year’s conference is offering three intensive sessions that will further delve into clinical and business topics: Emerging Trends in Dementia, Geriatric Care Management 101 and Social Networking Potential for Businesses and Clients.

Dr. Rex Swanda and Gregory MacKenzie, Esq., an expert in elder care estate planning, both of Albuquerque, will present “Objective and Clinical Markers for Decisional Capacity and Susceptibility to Undue Influence,” a discussion about the increased need for evaluations of cognitive disorders such as dementia.
The increase in older adults and high prevalence of psychiatric and neurological disorders in later life present a challenge for the health care system and families making decisions about health care, Swanda said.

The more dependent a person is on others, the more susceptible they are to manipulation.
When and individual starts to demonstrate impairment and a family or friend has suspicions about that individual’s decisional capacity related to health care, personal finances or legal estate planning, then an investigation is launched.

Swanda’s role in that process is to conduct a series of objective screenings for cognitive impairment, an examination of a person’s level of functioning and thinking abilities. These screenings cover things like attention, concentration, memory, language, the ability to express one’s wishes and demonstrating an understanding of what’s being asked of them.

Overall, these screenings aim to determine a person’s executive ability to plan and organize, to engage in complex problem solving and to express their own will, wishes and wants.

“Often a person is doing pretty well, they manage paying bills on time, et cetera, but sometimes by virtue of substance abuse or due to a fragile medical state and dependence on other people, it’s easy for others to come into their lives and control even who they might interact with,” Swanda said. “Mental fragility and being physically dependent together can be a dangerous combo. The state always has an interest in making sure the person can make the best use of their own thumbs and not sign their lives over.”

Anyone interested in guardianship issues would find this event very informative and useful, but so will folks who are concerned about where they will spend their later years.

The best advice in planning for the future is to start early, Swanda said. Questions worth asking include, “Who would I trust for power of attorney and financial planning? If I had a stroke tomorrow and couldn’t speak for myself, who would I trust to speak on my behalf?”

Loss of faculties is inevitable, Swanda said, but planning ahead is “a way to maintain control” into old age.